CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercyone Dubuque Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $163
  • Cash Discount Price: $742
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercyone Dubuque Medical Center is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $742. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 250 Mercy Drive, Dubuque, IA.
Cash / Self-Pay
$742

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $742 (695%)
Insurance Median: $163 (153%)
Cash: $742 (695% of Medicare)
Ins. Median: $163 (153% 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
Iowa Total Care $94 88%
Medicaid / KanCare $95 89%
Aetna $102 - $954 95%
Medicare (plans) $102 - $106 95%
Blue Cross Blue Shield $103 - $107 96%
UnitedHealthcare $104 - $1,142 97%
Stephenson Cty Health $105 98%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Amish Hospital Aid $138 129%
Oscar $142 133%
Centivo $163 153%
Ambetter / Centene $175 164%
Claimdoc $209 196%
Nova $209 196%
Geha $240 225%
Preferred Health Choice $408 382%
Health Choices $418 391%
Midlands Choice $662 - $1,028 620%
Wps $684 640%
The Alliance $690 646%
Mhnet $914 856%
1199 National Benefit Fund $954 893%
Allied Benefit Systems $954 893%
Asr Health Benefits $954 893%
Christian Brother Services $954 893%
Coventry $954 893%
First Health $954 893%
Lucent Health $954 893%
Luminare Health $954 893%
Medical Mutual $954 893%
Meritain $954 893%
Trustmark Small Business Benefits $954 893%
Webtpa $954 893%
Auxiant $1,028 962%
Cigna $1,028 962%
Medica $1,028 962%
Midlands $1,028 962%
Multiplan $1,028 962%
Unity $1,028 962%
Crime Victim Assistance $1,142 1069%
Iowa Dept Of Public Health $1,142 1069%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Mercy Drive, Dubuque, IA 52001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals