CMS Price Transparency Data

Ultrasound, pelvis

Facility: Henry County Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $136
Cash Discount Price: $174
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Henry County Memorial Hospital is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $174. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.27x the Medicare baseline. Located in 1000 N 16Th St, New Castle, IN.

Cash / Self-Pay

$174

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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: $174 (163%)

Insurance Median: $136 (127%)

Cash: $174 (163% of Medicare)

Ins. Median: $136 (127% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
UnitedHealthcare	$27 - $221	25%
Aetna	$30 - $230	28%
Humana	$30 - $239	28%
Blue Cross Blue Shield	$31 - $207	29%
Caresource Hip	$31 - $112	29%
Caresource Mcr Adv	$32 - $114	30%
Caresource Marketplace-All Other Plans	$42 - $213	39%
Caresource Just4Me	$47 - $280	44%
Encore Workers Comp-All Plans	$53 - $258	50%
Caresource Mcaid	$65 - $98	61%
Cigna	$113 - $184	106%
Health Alliance-All Plans	$192 - $230	180%
Workers Comp - All Plans	$204 - $244	191%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $174.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Henry County Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.