CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ochsner Choctaw General

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $161
Cash Discount Price: $270
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ochsner Choctaw General is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.51x the Medicare baseline. Located in 401 Vanity Fair Lane, Po Box 618, Butler, AL.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$161

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)

Cash / Self-Pay: $270 (253%)

Insurance Median: $161 (151%)

Cash: $270 (253% of Medicare)

Ins. Median: $161 (151% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Humana	$24 - $252	22%
Prime Health Services Ppo	$34 - $448	32%
Blue Cross Blue Shield	$37 - $517	35%
UnitedHealthcare	$40 - $308	37%
Aetna	$54 - $364	51%
Cigna	$54 - $308	51%
Primewell Health Services Commercial Exchange Plan	$57 - $375	53%
Primewell Health Services – Commercial	$57 - $375	53%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$68 - $252	64%
Medicare (plans)	$68 - $290	64%
Ambetter / Centene	$69 - $255	65%
Shared Health Mississippi	$71 - $265	66%
Medicaid / KanCare	$81 - $91	76%
Claritev D/B/A Multiplan/Phcs/American Life Care	$83 - $420	78%
Select Administrative Services Network	$94 - $392	88%
Zelis	$97 - $420	91%
Prime Health Services Ppo -Workers Comp	$120 - $447	112%
Cor Vel	$122 - $456	114%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $270.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Choctaw General is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.