CMS Price Transparency Data

Ultrasound, pelvis

Facility: Banner Fort Collins Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $277
Cash Discount Price: $279
vs. Medicare Baseline: 2.59x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Banner Fort Collins Medical Center is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $279. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.59x the Medicare baseline. Located in 4700 Lady Moon Dr, Fort Collins, CO.

Cash / Self-Pay

$279

Average discount available for prompt cash payment at this facility.

Insurance Median

$277

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: $279 (261%)

Insurance Median: $277 (259%)

Cash: $279 (261% of Medicare)

Ins. Median: $277 (259% 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 259% of the Medicare baseline (a markup of 159%). 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
UnitedHealthcare	$104 - $439	97%
Blue Cross Blue Shield	$107 - $456	100%
Cigna	$107	100%
Clear Spring Health	$107	100%
Healthspring Life & Health Insurance Company, Inc.	$107	100%
Medica	$107 - $331	100%
Medicare (plans)	$107	100%
Humana	$110	103%
Longevity	$110	103%
Devoted Health Services	$112	105%
Assist Health Group	$128	120%
Banner Health	$163	153%
Pinnacol Assurance Workers Comp	$168	157%
Denver Health Medical Plan	$191	179%
Centivo	$256	240%
Hue Health, Inc	$273 - $278	256%
Aetna	$328	307%
Rocky Mountain Health Plans	$335	314%
Apostrophe, Inc.	$337	316%
Decent Health	$337	316%
First Choice Health Network	$357	334%
Multiplan	$373	349%
First Choice Of The Midwest	$377	353%

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 $279.
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 Banner Fort Collins 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.