CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $721
  • Cash Discount Price: $790
  • vs. Medicare Baseline: 6.75x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Regional Medical Center is $721. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $790. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.75x the Medicare baseline. Located in 1010 Three Springs Blvd, Durango, CO.
Cash / Self-Pay
$790

Average discount available for prompt cash payment at this facility.

Insurance Median
$721

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: $790 (740%)
Insurance Median: $721 (675%)
Cash: $790 (740% of Medicare)
Ins. Median: $721 (675% 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 675% of the Medicare baseline (a markup of 575%). 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
Aetna $72 - $1,738 67%
Blue Cross Blue Shield $72 - $1,738 67%
Cigna $72 - $1,699 67%
Denver Health $72 - $583 67%
Humana $72 - $1,679 67%
Innovage $72 67%
Kaiser $72 67%
Medicare (plans) $72 67%
Rocky Mountain Pace $72 67%
UnitedHealthcare $72 - $245 67%
Archdiocese Of Denver $156 146%
Centura Employee Plan $205 192%
United Colorado Doctor'S Plan $245 229%
Direct To Employer $1,284 1202%
Presbyterian Health Plan $1,481 1387%
Multiplan $1,778 1665%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1010 Three Springs Blvd, Durango, CO 81301
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals