CMS Price Transparency Data

Ultrasound, pelvis

Facility: The Medical Center of Aurora & South Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,017
Cash Discount Price: $5,086
vs. Medicare Baseline: 9.52x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at The Medical Center of Aurora & South Hospital is $1,017. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,086. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.52x the Medicare baseline. Located in 1501 S Potomac St, Aurora, CO.

Cash / Self-Pay

$5,086

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,017

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: $5,086 (4762%)

Insurance Median: $1,017 (952%)

Cash: $5,086 (4762% of Medicare)

Ins. Median: $1,017 (952% 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 952% of the Medicare baseline (a markup of 852%). 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 - $3,763	75%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $4,577	165%
United	$185 - $2,288	173%
Rocky Mountain Health Plan	$245	229%
Cigna	$249 - $3,255	233%
Vail Health	$773	724%
Kaiser	$1,017 - $1,805	952%
Bright Health	$1,526	1429%
Colorado Program For Children With Special Needs	$2,136	2000%
Aetna	$2,685	2514%
Western Plains Community Health	$3,306	3095%
Northcare	$3,560	3333%
Physician Health Partners	$3,560	3333%
Medical Development International	$4,068	3809%
Prime Health	$4,577	4285%

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 $5,086.
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 The Medical Center of Aurora & South Hospital 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.