Ultrasound, pelvis
Facility: Lutheran Hospital of Indiana
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $237
- Cash Discount Price: $156
- vs. Medicare Baseline: 2.22x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 222% of the Medicare baseline (a markup of 122%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Physicians Health Plan Of Northern Indiana | $64 - $751 | 60% |
| Ky Work Comp | $65 - $480 | 61% |
| Amish Aid | $77 - $571 | 72% |
| Lutheran Preferred Network | $77 - $1,142 | 72% |
| Self Pay | $77 - $685 | 72% |
| Cigna | $83 - $691 | 78% |
| Php Freedom Network | $86 - $324 | 81% |
| Spreemo | $88 | 82% |
| Blue Cross Blue Shield | $96 - $706 | 90% |
| One Call Care Diagnostics | $98 | 92% |
| UnitedHealthcare | $98 - $938 | 92% |
| Veterans Eval Services | $98 | 92% |
| Aetna | $103 - $906 | 96% |
| Lutheran Preferred | $103 - $761 | 96% |
| Tricare | $105 | 98% |
| Humana | $109 - $245 | 102% |
| Iu Health Plan | $109 | 102% |
| Managed Health Services | $109 - $245 | 102% |
| Medicare (plans) | $109 | 102% |
| Department Of Veterans Affairs | $111 | 104% |
| Node Devoted Health Mcr Adv | $111 | 104% |
| Node Hospice Non Par Agree | $111 | 104% |
| Node Va | $111 | 104% |
| In Dept Of Correction | $115 | 108% |
| Node Pphp Mcr Adv | $116 | 109% |
| Sagamore | $118 - $1,030 | 110% |
| Encore Ppo | $126 - $931 | 118% |
| Lutheran Network | $129 - $952 | 121% |
| Us Department Of Labor | $138 | 129% |
| Lutheran Advanced Network | $166 | 155% |
| Node Lutheran Network | $166 - $194 | 155% |
| Node Lutheran Preferred Fixed 2 | $166 | 155% |
| Align Network | $177 | 166% |
| Multiplan | $188 - $1,579 | 176% |
| Prime Health Services | $194 - $1,427 | 182% |
| Encore Work Comp In | $199 | 186% |
| Encore Health Network | $212 - $1,713 | 198% |
| Advantage Health Solutions | $214 - $1,579 | 200% |
| Allied Benefit Systems | $232 - $1,713 | 217% |
| Evolutions | $232 - $1,713 | 217% |
| Care Source | $245 | 229% |
| Medicaid / KanCare | $245 | 229% |
| Node Encore Kba Epo | $265 | 248% |
| Node Encore Kba Ppo | $332 | 311% |