CMS Price Transparency Data

Ultrasound, pelvis

Facility: Kootenai Health

Billing Code: 76856 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$86

about 0.8× the $107 Medicare rate · typically $86–$93

modeled estimate · not a bill or quote

What this hospital charges insurers

$87

About the fair price

about $1 over the fair price · 0.8× Medicare

Medicare pays $107 Fair price $86 This hospital $87 Cash price $498 Hospital's list price $664

How we calculate the fair BaseRate →

How this hospital compares to other ID hospitals

A typical price — 3 charge more and 5 charge less, among the 9 ID hospitals compared.

Cheapest $29 Priciest $103

Black dot = this hospital, among the 9 ID hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Ultrasound, pelvis is about $86 (about 0.8× the $107 Medicare rate). Kootenai Health charges insurers about $87, or about $498 in cash — about the fair price. Located in Coeur D'Alene, ID.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$31 - $598	29%
Blue Cross Blue Shieldmajor	$31 - $604	29%
Aetnamajor	$33 - $551	31%
Cignamajor	$544 - $552	509%
Humanamajor	$31 - $108	29%
Kaiser Permanentemajor	$44 - $389	41%
Molina	$20 - $246	19%
PacificSource	$31 - $544	29%
+ 5 smaller / regional plans	$20 - $575

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 498), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 76856.

Insurance Before you use insurance

Call your insurance company to confirm Kootenai Health is in-network.
Ask your insurer whether prior approval is required for CPT code 76856.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Kootenai Health

Compare: Ultrasound, pelvis at other ID hospitals

Insurance negotiated median for the same procedure, sorted lowest first.