CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $555
Cash Discount Price: $1,885
vs. Medicare Baseline: 5.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Healthone Presbyterian St Luke's is $555. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,885. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.20x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$1,885

Average discount available for prompt cash payment at this facility.

Insurance Median

$555

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: $1,885 (1765%)

Insurance Median: $555 (520%)

Cash: $1,885 (1765% of Medicare)

Ins. Median: $555 (520% 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 520% of the Medicare baseline (a markup of 420%). 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
Blue Cross Blue Shield	$80 - $2,055	75%
Vail Health	$151 - $422	141%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $2,499	165%
United	$185 - $1,249	173%
Kaiser	$199 - $722	186%
Rocky Mountain Health Plan	$245	229%
Cigna	$288 - $1,777	270%
Aetna	$298 - $1,466	279%
Bright Health	$298 - $833	279%
Emerging Therapy Solutions	$477 - $1,777	447%
Kaiser National Transplant	$477 - $1,333	447%
Colorado Program For Children With Special Needs	$507 - $1,416	475%
Western Plains Community Health	$646 - $1,805	605%
Northcare	$696 - $1,944	652%
Physician Health Partners	$696 - $1,944	652%
Medical Development International	$795 - $2,221	744%
Prime Health	$894 - $2,499	837%

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 $1,885.
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 HCA Healthone Presbyterian St Luke's 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.