CMS Price Transparency Data

Ultrasound, pelvis

Facility: Southeast Iowa Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $155
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Southeast Iowa Regional Medical Center is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.45x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$155

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%)
Insurance Median: $155 (145%)
Ins. Median: $155 (145% 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.

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
American Healthplan Of Iowa - Midlevel $25 - $81 23%
Medicaid / KanCare $29 - $90 27%
Aetna $30 - $95 28%
Humana $32 - $99 30%
American Healthplan Of Iowa - Md $34 - $107 32%
Blue Cross Blue Shield $58 - $417 54%
UnitedHealthcare $63 - $199 59%
Immergrun $67 63%
Midlands Choice $69 - $882 65%
6 Degree $85 - $784 80%
Plain Church $112 - $637 105%
Absolute Solutions $156 - $314 146%
First Agency $156 - $314 146%
Multiplan $156 - $314 146%
Henderson County $164 - $332 154%
Elap $200 - $286 187%
Wellpoint (Amerigroup) $266 - $549 249%
Immugrun $299 - $617 280%
Brighton Amish Church $309 - $637 289%
Geha $442 - $911 414%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1221 South Gear Avenue, West Burlington, IA 52655
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals