CMS Price Transparency Data

Ultrasound, pelvis

Facility: Sarah Bush Lincoln Health Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $159
  • Cash Discount Price: $936
  • vs. Medicare Baseline: 1.49x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Sarah Bush Lincoln Health Center is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $936. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.49x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$936

Average discount available for prompt cash payment at this facility.

Insurance Median
$159

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: $936 (876%)
Insurance Median: $159 (149%)
Cash: $936 (876% of Medicare)
Ins. Median: $159 (149% 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
Aetna $32 - $1,516 30%
Bc Comm Mmai $32 - $120 30%
Beacon Health Options Behav-All Plans $32 - $120 30%
Hlth Alliance Mcr Adv $32 - $120 30%
Humana $32 - $122 30%
Meridian Mcaid $32 - $211 30%
Meridian Mmai-All Other Plans $32 - $120 30%
Molina Mmai-All Other Plans $32 - $120 30%
Tricare $32 - $120 30%
UnitedHealthcare $32 - $1,399 30%
Va Ccn-All Plans $32 - $120 30%
Wellcare Med Adv-All Plans $32 - $120 30%
Bc Med Adv Ppo/Hmo $33 - $124 31%
Blue Cross Blue Shield $41 - $1,348 38%
First Health-All Plans $48 - $1,432 45%
Multiplan-All Plans $60 - $1,449 56%
Plain Church Mg-All Plans $74 - $674 69%
Mennonite-All Plans $84 - $758 79%
Eiu Athlete-All Other Plans $130 - $1,180 122%
Healthscope-All Plans $138 - $1,247 129%
Rural King-All Plans $138 - $1,247 129%
Hope Trust-All Plans $149 - $1,348 140%
Eiu Student $153 - $1,382 143%
Allied National-All Plans $156 - $1,415 146%
Companion Life-All Plans $156 - $1,415 146%
Innovative Hlthware-All Plans $158 - $1,432 148%
Healthlink Hmo $160 - $1,449 150%
Healthlink Ppo - All Other Plans $160 - $1,449 150%
Cigna $167 - $1,516 156%
Consociate-All Plans $167 - $1,348 156%
Cphp-All Plans $167 - $1,516 156%
Beech Street-All Plans $171 - $1,550 160%
Hfn-All Plans $171 - $1,550 160%
Bc Comm Care Mcaid $186 - $211 174%
Hlth Alliance Mcaid $186 - $211 174%
Molina Mcaid $186 - $211 174%
Hlth Alliance-All Other Plans $1,415 1325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals