CMS Price Transparency Data

Ultrasound, pelvis

Facility: Gunnison Valley Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $480
Cash Discount Price: $680
vs. Medicare Baseline: 4.49x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Gunnison Valley Hospital is $480. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $680. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.49x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$680

Average discount available for prompt cash payment at this facility.

Insurance Median

$480

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: $680 (637%)

Insurance Median: $480 (449%)

Cash: $680 (637% of Medicare)

Ins. Median: $480 (449% 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 449% of the Medicare baseline (a markup of 349%). 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
Cigna	$29 - $784	27%
Medicare (plans)	$32 - $392	30%
Aetna	$46 - $768	43%
Apostrophe-All Plans	$52 - $720	49%
Medicaid / KanCare	$91 - $225	85%
Gunnison County Sheriff Op & Profee Only	$114 - $411	107%
Ebms Hdhp	$134 - $480	125%
Tetwp Op & Profee Only-All Plans	$134 - $480	125%
U Of Co Transplant-All Plans	$134 - $480	125%
Ebms Ppo Plan-All Other Plans	$156 - $560	146%
Gunnison County Employees-All Other Plans	$178 - $640	167%
Scottish Rites-All Plans	$178 - $640	167%
Elap Employers-All Plans	$190 - $680	178%
Blue Cross Blue Shield	$195 - $701	183%
Multiplan-All Plans	$201 - $744	188%
Rocky Mountain Health-All Plans	$212 - $760	198%
UnitedHealthcare	$212 - $760	198%
Cofinity-All Plans	$214 - $768	200%
Gunnison County Coroner Op Only	$410 - $411	384%

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 $680.
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 Gunnison Valley 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.