CMS Price Transparency Data

Ultrasound, pelvis

Facility: St Elizabeth Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $900
  • Cash Discount Price: $691
  • vs. Medicare Baseline: 8.43x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at St Elizabeth Hospital is $900. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $691. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.43x the Medicare baseline. Located in 1000 Lincoln St, Fort Morgan, CO.
Cash / Self-Pay
$691

Average discount available for prompt cash payment at this facility.

Insurance Median
$900

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: $691 (647%)
Insurance Median: $900 (843%)
Cash: $691 (647% of Medicare)
Ins. Median: $900 (843% 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 843% of the Medicare baseline (a markup of 743%). 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.

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
Aetna $72 - $1,676 67%
Blue Cross Blue Shield $72 - $900 67%
Cigna $72 - $1,676 67%
Denver Health $72 - $759 67%
Devoted Health $72 67%
Humana $72 67%
Kaiser $72 67%
Medicare (plans) $72 67%
UnitedHealthcare $72 - $1,491 67%
Centura Employee Plan $205 192%
United Colorado Doctor'S Plan $1,343 1257%
Direct To Employer $1,417 1327%
Multiplan $1,624 - $1,676 1520%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Lincoln St, Fort Morgan, CO 80701
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals