CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Hospital Northwest Arkansas

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $126
  • Cash Discount Price: $506
  • vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Northwest Arkansas is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.18x the Medicare baseline. Located in 2710 South Rife Medical Lane, Rogers, AR.
Cash / Self-Pay
$506

Average discount available for prompt cash payment at this facility.

Insurance Median
$126

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: $506 (474%)
Insurance Median: $126 (118%)
Cash: $506 (474% of Medicare)
Ins. Median: $126 (118% 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.

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
Arkansas Department Of Health [20036] $40 37%
Medicaid / KanCare $40 - $137 37%
Summit Community Care Contracted [320368] $40 37%
Summit Community Care [20368] $40 37%
Aetna $90 - $126 84%
Humana $90 - $623 84%
Arkansas Total Care Contracted [320039] $91 85%
Arkansas Total Care [20039] $91 85%
American Health Advantage Of Mo Mcr [20264] $96 90%
Blue Cross Blue Shield $96 - $103 90%
Cherokee Nation Health Serv Contracted [320066] $96 90%
Cigna $96 - $142 90%
Cross Timbers Hospice [20098] $96 90%
Dept Of Veteran Affairs Contracted [320106] $96 90%
Elara Caring Aspire Hospice Contracted [320433] $96 90%
Elara Caring Aspire Hospice [20433] $96 90%
Globalhealth Contracted [320145] $96 90%
Halo Hcr Inc Hospice Contracted [320432] $96 90%
Halo Hcr Inc Hospice [20432] $96 90%
Independent Health [20197] $96 90%
Jordan Valley Senior Care Pace [20515] $96 90%
Kindful Hospice Contracted [320434] $96 90%
Kindful Hospice [20434] $96 90%
Medical Associates Health [20444] $96 90%
Medicare (plans) $96 - $100 90%
Mercy Hospice Okc [20252] $96 90%
Pace Of The Ozarks [20518] $96 90%
Provider Partners Health Plans Contracted [320450] $96 90%
Qual Choice Contracted [320325] $96 90%
Spina Bifida Hlthcare Benefit [20506] $96 90%
Tribute Health Plan Mcr [20338] $96 90%
Tricare $96 90%
UnitedHealthcare $96 - $224 90%
Valir Pace [20503] $96 90%
Wellfirst Health Mcr [20443] $96 90%
Usable Contracted [320409] $103 96%
St Johns Mercy Rehab Llc Contracted [320359] $107 100%
St Johns Mercy Rehab Llc [20359] $107 100%
Ambetter / Centene $137 128%
Home State Health Plan Contracted [320187] $137 128%
Novasys Contracted [320285] $137 - $138 128%
Mercy Interfacility [20513] $142 133%
First Health Contracted [320128] $177 166%
Aither Health Contracted [320449] $195 183%
Edison Health Solutions Contracted [320502] $195 183%
Mercy Benefit Admin Contracted [320251] $195 - $467 183%
Yuzu Health Contracted [320521] $195 183%
Health Choice Contracted [320166] $213 199%
United Medical Resources Contracted [320454] $224 210%
Qual Choice Contracted [320324] $253 237%
90 Degree Benefits Contracted [320436] $390 365%
Show-Me Health Administrators Contracted [320483] $390 365%
Auxiant Contracted [320462] $467 - $506 437%
Ebms Contracted [320493] $467 437%
Healthlink Contracted [320179] $467 - $506 437%
Imagine 360 Contracted [320494] $467 437%
Municipal Health Plan Contracted [320271] $467 437%
Reflect Health Contracted [320492] $467 437%
Benefit Management Contracted [320052] $506 474%
Federal Medical Center Contracted [320127] $506 474%
Insurance System Inc Contracted [320465] $506 474%
Personify Health Contracted [320051] $506 474%
Point C Contracted [320238] $506 474%
Preferred Health Plan Contracted [320522] $506 474%
Tri State Healthcare Coalition Contracted [320379] $506 474%
Workers Comp [20426] $506 474%
Employers Health Coalition Contracted [320116] $545 510%
Private Health Care Systems Contracted [320320] $569 533%
Private Health Care Systems [20320] $569 533%
Ppo Plus Contracted [320310] $584 547%
Healthscope Contracted [320182] $623 583%
Multiplan Contracted [320270] $662 620%
Multiplan [20270] $662 620%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2710 South Rife Medical Lane, Rogers, AR 72758
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals