CMS Price Transparency Data

Ultrasound, pelvis

Facility: Atrium Health Navicent Peach

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $123
Cash Discount Price: $306
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Atrium Health Navicent Peach is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $306. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$306

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $306 (286%)

Insurance Median: $123 (115%)

Cash: $306 (286% of Medicare)

Ins. Median: $123 (115% 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.

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
Aetna	$35 - $360	33%
Blue Cross Blue Shield	$35 - $128	33%
Georgia Health Advantage	$35 - $128	33%
Humana	$35 - $519	33%
UnitedHealthcare	$35 - $385	33%
Care Source	$36 - $131	34%
Clover	$36 - $131	34%
Eon Health	$36 - $131	34%
Alliant	$37 - $299	35%
Pruitt Health	$37 - $128	35%
Ambetter / Centene	$40 - $312	37%
Cigna	$76 - $445	71%
Securehealth	$81 - $397	76%
Multiplan	$397 - $489	372%
Novanet	$489	458%
Three Rivers Provider Network	$519	486%
Beechstreet	$568	532%

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 $306.
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 Atrium Health Navicent Peach 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.