CMS Price Transparency Data

Ultrasound, pelvis

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $409
Cash Discount Price: $762
vs. Medicare Baseline: 3.83x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at University of Iowa Health Care Medical Center Down is $409. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $762. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.83x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$762

Average discount available for prompt cash payment at this facility.

Insurance Median

$409

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: $762 (713%)

Insurance Median: $409 (383%)

Cash: $762 (713% of Medicare)

Ins. Median: $409 (383% 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 383% of the Medicare baseline (a markup of 283%). 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
Immergrun	$80 - $272	75%
Aetna	$94 - $652	88%
Iowa Total Care	$94 - $436	88%
Medical Associates	$94 - $544	88%
Molina Healthcare	$94 - $436	88%
UnitedHealthcare	$94 - $583	88%
Blue Cross Blue Shield	$95 - $523	89%
Healthpartners	$96 - $926	90%
Wellpoint (Amerigroup)	$99 - $105	93%
Oscar Health	$201 - $686	188%
Great River Health Systems	$223 - $762	209%
Quad City Community Healthcare	$239 - $817	224%
Aplos Health Plan	$244 - $871	228%
Sedgwick	$255 - $871	239%
Global Excel	$271 - $926	254%
Sanford Health Plan	$271 - $926	254%
Midlands Choice	$280 - $708	262%
Employee Benefit Systems	$281 - $980	263%
Sisco	$281 - $958	263%
Healthsmart	$287 - $980	269%
Hfn	$293 - $1,002	274%
Multiplan	$293 - $1,002	274%

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 $762.
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 University of Iowa Health Care Medical Center Down 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.