CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lawrence Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $78
Cash Discount Price: $125
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lawrence Memorial Hospital is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.73x the Medicare baseline. Located in 1309 West Main Street, Walnut Ridge, AR.

Cash / Self-Pay

$125

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $125 (117%)

Insurance Median: $78 (73%)

Cash: $125 (117% of Medicare)

Ins. Median: $78 (73% 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
Ambetter / Centene	$30 - $152	28%
Humana	$30 - $118	28%
Allwell	$31 - $123	29%
Blue Cross Blue Shield	$31 - $155	29%
Wellcare	$31 - $205	29%
Amerigroup	$32 - $117	30%
Arkansas Superior Select	$32 - $114	30%
Provider Partners Health Plans	$32 - $114	30%
Wellcare By Allwell	$32 - $114	30%
Wellcare Health Plans	$32 - $114	30%
Qualchoice	$34 - $152	32%
Qualchoice Of Arkansas	$35 - $141	33%
Cigna	$36 - $117	34%
Covenant Healthcare	$39 - $123	37%
Arkansas Total Care	$40 - $117	37%
Empower Healthcare Solutions	$42 - $122	39%
Assured Benefits Administrators	$48 - $174	45%
Caresource	$57 - $92	53%
Aetna	$164	154%
Healthlink	$191	179%

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 $125.
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 Lawrence Memorial Hospital 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.