CMS Price Transparency Data

Ultrasound, pelvis

Facility: Finley Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $105
Cash Discount Price: $216
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Finley Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $216. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 350 North Grandview Avenue, Dubuque, IA.

Cash / Self-Pay

$216

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $216 (202%)

Insurance Median: $105 (98%)

Cash: $216 (202% of Medicare)

Ins. Median: $105 (98% 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	$30 - $287	28%
Blue Cross Blue Shield	$31 - $219	29%
Molina	$31 - $104	29%
Amerivantage	$32 - $107	30%
Humana	$32 - $107	30%
Meridian	$32 - $118	30%
UnitedHealthcare	$32 - $224	30%
Medical Associates Health Plan	$45 - $194	42%
Wellmark Uph Self-Funded	$58 - $186	54%
Cigna	$63 - $514	59%
Health Partners Open Network	$63 - $210	59%
Bc Illinois Community	$75 - $420	70%
Dean Health Plan	$93 - $779	87%
Amerigroup	$94	88%
Iowa Total Care	$94	88%
Medica Exchange Inspire	$358	335%
Medica Exchange Insure	$401	375%
Quartz Health	$779	729%

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 $216.
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 Finley 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.