CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Hospital Paris

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $252
Cash Discount Price: $508
vs. Medicare Baseline: 2.36x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Paris is $252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $508. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.36x the Medicare baseline. Located in 500 East Academy, Paris, AR.

Cash / Self-Pay

$508

Average discount available for prompt cash payment at this facility.

Insurance Median

$252

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: $508 (476%)

Insurance Median: $252 (236%)

Cash: $508 (476% of Medicare)

Ins. Median: $252 (236% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 236% of the Medicare baseline (a markup of 136%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$40 - $306	37%
Summit Community Care Contracted [320368]	$40	37%
Summit Community Care [20368]	$40	37%
Arkansas Total Care Contracted [320039]	$91	85%
Arkansas Total Care [20039]	$91	85%
Blue Cross Blue Shield	$108 - $222	101%
Usable Contracted [320409]	$108	101%
Novasys Contracted [320285]	$143 - $306	134%
Aetna	$222 - $508	208%
American Health Advantage Of Mo Mcr [20264]	$222	208%
Cherokee Nation Health Serv Contracted [320066]	$222	208%
Cross Timbers Hospice [20098]	$222	208%
Dept Of Veteran Affairs Contracted [320106]	$222	208%
Elara Caring Aspire Hospice Contracted [320433]	$222	208%
Elara Caring Aspire Hospice [20433]	$222	208%
Globalhealth Contracted [320145]	$222	208%
Halo Hcr Inc Hospice Contracted [320432]	$222	208%
Halo Hcr Inc Hospice [20432]	$222	208%
Humana	$222 - $664	208%
Indian Health Service Contracted [320198]	$222	208%
Indian Health Service [20198]	$222	208%
Jordan Valley Senior Care Pace [20515]	$222	208%
Kindful Hospice Contracted [320434]	$222	208%
Kindful Hospice [20434]	$222	208%
Medicare (plans)	$222 - $233	208%
Mercy Hospice Okc [20252]	$222	208%
Pace Of The Ozarks [20518]	$222	208%
Provider Partners Health Plans Contracted [320450]	$222	208%
Qual Choice Contracted [320325]	$222	208%
Spina Bifida Hlthcare Benefit [20506]	$222	208%
UnitedHealthcare	$222 - $252	208%
Valir Pace [20503]	$222	208%
Tricare	$223	209%
Cigna	$233 - $664	218%
United Medical Resources Contracted [320454]	$252	236%
Qual Choice Contracted [320324]	$253	237%
Ambetter / Centene	$306	286%
Home State Health Plan Contracted [320187]	$306	286%
Mercy Interfacility [20513]	$333	312%
Auxiant Contracted [320462]	$469 - $703	439%
Mercy Benefit Admin Contracted [320251]	$469 - $703	439%
Workers Comp [20426]	$508	476%
90 Degree Benefits Contracted [320436]	$664	622%
Aither Health Contracted [320449]	$664	622%
Ebms Contracted [320493]	$664	622%
Edison Health Solutions Contracted [320502]	$664	622%
Healthlink Contracted [320179]	$664 - $703	622%
Imagine 360 Contracted [320494]	$664	622%
Multiplan Contracted [320270]	$664	622%
Multiplan [20270]	$664	622%
Municipal Health Plan Contracted [320271]	$664	622%
Reflect Health Contracted [320492]	$664	622%
Show-Me Health Administrators Contracted [320483]	$664	622%
Federal Medical Center Contracted [320127]	$703	658%
Healthscope Contracted [320182]	$703	658%
Insurance System Inc Contracted [320465]	$703	658%
Personify Health Contracted [320051]	$703	658%
Point C Contracted [320238]	$703	658%
Preferred Health Plan Contracted [320522]	$703	658%
Tri State Healthcare Coalition Contracted [320379]	$703	658%

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 $508.
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 Mercy Hospital Paris 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.