CMS Price Transparency Data

Ultrasound, pelvis

Facility: Norton Clark Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $115
  • Cash Discount Price: $146
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Norton Clark Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.08x the Medicare baseline. Located in 1220 Missouri Ave, Jeffersonville, IN.
Cash / Self-Pay
$146

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $146 (137%)
Insurance Median: $115 (108%)
Cash: $146 (137% of Medicare)
Ins. Median: $115 (108% 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
Blue Cross Blue Shield $63 - $481 59%
Caresource Indiana Healthy Indiana Plan (Hip) $63 59%
Humana $63 59%
Managed Health Services (Mhs) Hoosier Care Connect $63 59%
Managed Health Services (Mhs) Hoosier Healthwise (Hhw) $63 59%
Caresource Indiana Hoosier Healthwise (Hhw) $65 61%
UnitedHealthcare $65 - $425 61%
Mdwise Hoosier Healthwise (Hhw) $66 62%
Molina Healthcare Of Indiana $67 - $115 63%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip) $111 104%
Mdwise Health Indiana Plan (Hip) $111 104%
Aetna $115 - $494 108%
Communicare Advantage $115 108%
Managed Health Services (Mhs) $117 - $162 110%
Cigna $425 398%
Ppom $914 856%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1220 Missouri Ave, Jeffersonville, IN 47130
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals