CMS Price Transparency Data

Ultrasound, pelvis

Facility: San Luis Valley Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $390
Cash Discount Price: $238
vs. Medicare Baseline: 3.65x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at San Luis Valley Regional Medical Center is $390. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.65x the Medicare baseline. Located in 106 Blanca Ave, Alamosa, CO.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$390

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: $238 (223%)

Insurance Median: $390 (365%)

Cash: $238 (223% of Medicare)

Ins. Median: $390 (365% 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 365% of the Medicare baseline (a markup of 265%). 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
Uc Health Plan Pb	$80	75%
Rocky Mountain	$104	97%
Tricare	$107 - $110	100%
Kaiser	$110 - $545	103%
Triwest	$110	103%
Aetna	$161 - $502	151%
Multiplan Physician	$161	151%
Cigna	$191 - $545	179%
Rocky Mountain Pb	$191	179%
Uchpa Phs - Pb	$191	179%
Presbyterian Health Plan	$248	232%
Co Choice Healthplan - Lutheran Hosp Assoc	$390	365%
Hmo Health Plans	$402	376%
UnitedHealthcare	$504 - $528	472%
Blue Cross Blue Shield	$505	473%
Galaxy Health Network	$505	473%
Multiplan	$505 - $517	473%
Humana	$517	484%
Pinnacol Assurance	$534	500%
Colorado Access	$542	507%
Foundation Health Corp	$545	510%
Uc Health Plan	$545	510%
Uchpa Phs	$545	510%

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 $238.
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 San Luis Valley Regional Medical Center 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.