Ultrasound, pelvis
Facility: Bluffton Regional Medical Center
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $227
- Cash Discount Price: $151
- vs. Medicare Baseline: 2.13x 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 213% of the Medicare baseline (a markup of 113%). 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 |
|---|---|---|
| Amish Aid | $62 - $577 | 58% |
| Self Pay | $62 - $1,322 | 58% |
| Physicians Health Plan | $63 - $235 | 59% |
| Lutheran Preferred Network | $77 - $1,923 | 72% |
| Php Freedom Network | $81 - $305 | 76% |
| Cigna | $82 - $851 | 77% |
| Php | $82 - $265 | 77% |
| Aetna | $93 - $1,072 | 87% |
| UnitedHealthcare | $98 - $1,188 | 92% |
| Veterans Eval Services | $98 | 92% |
| Php Management Systems | $100 - $931 | 94% |
| Lutheran Trma | $103 - $1,082 | 96% |
| Tricare | $105 | 98% |
| Blue Cross Blue Shield | $109 - $455 | 102% |
| Medicare (plans) | $109 | 102% |
| Node Iu Health Mcr Adv | $109 | 102% |
| Node Mhs Mcr Adv | $109 | 102% |
| Department Of Veterans Affairs | $111 | 104% |
| Humana | $111 - $245 | 104% |
| Node Caresource Mcr Adv | $111 | 104% |
| Node Devoted Health Mcr Adv | $111 | 104% |
| Node Non Par Hospice Agree | $111 | 104% |
| Node Va | $111 | 104% |
| Northeast Hospice | $111 | 104% |
| County Jail Health Care | $115 | 108% |
| In Dept Of Correction | $115 | 108% |
| Node Pphp Mcr Adv | $116 | 109% |
| Encore Ppo | $126 - $1,176 | 118% |
| Sagamore Sebt | $132 - $1,228 | 124% |
| Sagamore Health Newtork Inc | $138 - $1,289 | 129% |
| Us Department Of Labor | $138 | 129% |
| Consumer Life | $160 - $1,490 | 150% |
| Lutheran Advanced Network | $166 | 155% |
| Lutheran Three Rivers Preferred Plus 150 | $166 | 155% |
| Ahg Dana Employees | $168 - $1,563 | 157% |
| Align Networks | $181 - $1,683 | 169% |
| Lutheran Three Rivers Preferred Plus 175 | $194 | 182% |
| Prime Health Services | $194 - $1,803 | 182% |
| Private Healthcare Systems Inc | $194 - $1,803 | 182% |
| Encore Work Comp In | $199 | 186% |
| Multiplan | $206 - $1,923 | 193% |
| Encore Health Network | $212 - $2,164 | 198% |
| Advantage 360 | $214 - $1,995 | 200% |
| Community Health Alliance | $219 - $2,043 | 205% |
| Lutheran Northwest Health Preferred | $221 | 207% |
| Managed Health Services Exchange | $221 | 207% |
| Workers Compensation | $221 | 207% |
| First Health | $222 - $2,067 | 208% |
| Allied Benefit Systems | $232 - $2,164 | 217% |
| Cardinal Health Alliance | $232 - $2,164 | 217% |
| Ppom | $232 - $2,164 | 217% |
| Caresource | $245 | 229% |
| Medicaid / KanCare | $245 | 229% |
| Mhs | $245 | 229% |
| Mhs In Hip | $245 | 229% |
| Encore Kba Epo | $265 | 248% |
| Encore Kba Ppo | $332 | 311% |