CMS Price Transparency Data
Ultrasound, pelvis
Facility: Mercy Hospital Booneville
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $241
- Cash Discount Price: $508
- vs. Medicare Baseline: 2.26x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Booneville is $241. 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 2.26x the Medicare baseline. Located in 880 West Main, Booneville, AR.
Cash / Self-Pay
$508
Average discount available for prompt cash payment at this facility.
Insurance Median
$241
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: $241 (226%)
Cash: $508 (476% of Medicare)
Ins. Median: $241 (226% 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 - $317 | 37% |
| Summit Community Care Contracted [320368] | $40 | 37% |
| Summit Community Care [20368] | $40 | 37% |
| Aetna | $90 - $508 | 84% |
| Humana | $90 - $230 | 84% |
| Arkansas Total Care Contracted [320039] | $91 | 85% |
| Arkansas Total Care [20039] | $91 | 85% |
| Blue Cross Blue Shield | $108 - $230 | 101% |
| Usable Contracted [320409] | $108 | 101% |
| American Health Advantage Of Mo Mcr [20264] | $230 | 215% |
| Cherokee Nation Health Serv Contracted [320066] | $230 | 215% |
| Cross Timbers Hospice [20098] | $230 | 215% |
| Dept Of Veteran Affairs Contracted [320106] | $230 | 215% |
| Elara Caring Aspire Hospice Contracted [320433] | $230 | 215% |
| Elara Caring Aspire Hospice [20433] | $230 | 215% |
| Globalhealth Contracted [320145] | $230 | 215% |
| Halo Hcr Inc Hospice Contracted [320432] | $230 | 215% |
| Halo Hcr Inc Hospice [20432] | $230 | 215% |
| Independent Health [20197] | $230 | 215% |
| Indian Health Service Contracted [320198] | $230 | 215% |
| Indian Health Service [20198] | $230 | 215% |
| Jordan Valley Senior Care Pace [20515] | $230 | 215% |
| Kindful Hospice Contracted [320434] | $230 | 215% |
| Kindful Hospice [20434] | $230 | 215% |
| Medical Associates Health [20444] | $230 | 215% |
| Medicare (plans) | $230 - $242 | 215% |
| Mercy Hospice Okc [20252] | $230 | 215% |
| Pace Of The Ozarks [20518] | $230 | 215% |
| Provider Partners Health Plans Contracted [320450] | $230 | 215% |
| Qual Choice Contracted [320325] | $230 | 215% |
| Spina Bifida Hlthcare Benefit [20506] | $230 | 215% |
| UnitedHealthcare | $230 - $252 | 215% |
| Valir Pace [20503] | $230 | 215% |
| Wellfirst Health Mcr [20443] | $230 | 215% |
| Tricare | $231 | 216% |
| Cigna | $242 - $665 | 227% |
| United Medical Resources Contracted [320454] | $252 | 236% |
| Qual Choice Contracted [320324] | $253 | 237% |
| Ambetter / Centene | $317 | 297% |
| Home State Health Plan Contracted [320187] | $317 | 297% |
| Novasys Contracted [320285] | $317 | 297% |
| Mercy Interfacility [20513] | $382 | 358% |
| Auxiant Contracted [320462] | $469 - $665 | 439% |
| Mercy Benefit Admin Contracted [320251] | $469 - $665 | 439% |
| Workers Comp [20426] | $508 | 476% |
| Multiplan Contracted [320270] | $626 | 586% |
| Private Health Care Systems Contracted [320320] | $626 | 586% |
| 90 Degree Benefits Contracted [320436] | $665 | 623% |
| Aither Health Contracted [320449] | $665 | 623% |
| Ebms Contracted [320493] | $665 | 623% |
| Edison Health Solutions Contracted [320502] | $665 | 623% |
| Federal Medical Center Contracted [320127] | $665 | 623% |
| Healthlink Contracted [320179] | $665 | 623% |
| Healthscope Contracted [320182] | $665 | 623% |
| Imagine 360 Contracted [320494] | $665 | 623% |
| Insurance System Inc Contracted [320465] | $665 | 623% |
| Personify Health Contracted [320051] | $665 | 623% |
| Point C Contracted [320238] | $665 | 623% |
| Ppo Plus Contracted [320310] | $665 | 623% |
| Preferred Health Plan Contracted [320522] | $665 | 623% |
| Reflect Health Contracted [320492] | $665 | 623% |
| Show-Me Health Administrators Contracted [320483] | $665 | 623% |
| Tri State Healthcare Coalition Contracted [320379] | $665 | 623% |
| Municipal Health Plan Contracted [320271] | $704 | 659% |