CMS Price Transparency Data

Ultrasound, pelvis

Facility: Eastern Idaho Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $585
  • Cash Discount Price: $1,170
  • vs. Medicare Baseline: 5.48x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Eastern Idaho Regional Medical Center is $585. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,170. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.48x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.
Cash / Self-Pay
$1,170

Average discount available for prompt cash payment at this facility.

Insurance Median
$585

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: $1,170 (1095%)
Insurance Median: $585 (548%)
Cash: $1,170 (1095% of Medicare)
Ins. Median: $585 (548% 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 548% of the Medicare baseline (a markup of 448%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $26 - $1,111 24%
Molina $26 - $55 24%
Interwest Health $151 - $1,053 141%
Regence $225 211%
United $245 - $676 229%
Select Health $354 331%
Select Health Ichn Brightpath $354 - $395 331%
Select Health Idaho (Eirmc Only) $373 349%
Aetna $461 - $570 432%
Doug Andrus Distributing $468 438%
Pacificsource Health $491 - $627 460%
University Of Utah $491 460%
Mountain Health Co-Op $585 - $877 548%
Cigna $643 602%
First Choice Health Of Washington $702 657%
Moda $729 683%
Dmba $753 705%
Prime Health $877 - $994 821%
Geha Ppo Usa $936 876%
Humana $982 919%
Multiplan $982 - $1,053 919%
First Choice Of The Midwest $1,053 986%
St. John'S Health Network $1,053 986%
Coventry First Health $1,064 996%
Shashone-Bannock Tribal Health $1,170 1095%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Channing Way, Idaho Falls, ID 83404
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals