CMS Price Transparency Data

Ultrasound, pelvis

Facility: Kosciusko Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $218
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 2.04x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Kosciusko Community Hospital is $218. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.04x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$218

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: $107 (100%)
Insurance Median: $218 (204%)
Cash: $107 (100% of Medicare)
Ins. Median: $218 (204% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 204% of the Medicare baseline (a markup of 104%). 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.

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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 $54 - $478 51%
Self Pay $54 - $887 51%
Lutheran Preferred Network $82 - $1,819 77%
Physicians Health Plan $95 - $1,048 89%
One Call Care Diagnostics Wc $98 92%
Veterans Eval Services $98 92%
Php Freedom Network $100 - $878 94%
UnitedHealthcare $101 - $1,196 95%
Encore $103 - $910 96%
Trma Inc $103 - $1,023 96%
Tricare $105 98%
Aetna $106 - $1,210 99%
Department Of Veterans Affairs $111 104%
Blue Cross Blue Shield $117 - $455 110%
Humana $117 - $245 110%
Medicare (plans) $117 110%
Mhs $117 - $245 110%
Iu Health $118 110%
Node Non Par Hospice Agree $118 110%
Node Va $118 110%
Node Devoted Health Mcr Adv $119 111%
In Dept Of Correction $123 115%
Node Pphp Mcr Adv $124 116%
Us Department Of Labor $148 139%
Connecticut General Life Insurance Company $152 - $1,339 142%
Cigna $163 - $1,437 153%
Lutheran Advanced Network $178 167%
Lutheran Preferred $178 - $237 167%
Caresource $189 - $245 177%
Align In Work Comp $190 178%
One Call Work Comp $190 178%
First Health Network $194 - $1,706 182%
Prime Health Services $194 - $1,706 182%
Encore Work Comp In $213 199%
Advantage Health $214 - $1,887 200%
Private Healthcare Systems $222 - $1,956 208%
Sagamore $227 - $2,138 213%
Managed Health Services Exchange $237 222%
Workers Comp $237 222%
Encore Health Network $240 - $2,115 225%
Managed Health Services $245 229%
Medicaid / KanCare $245 229%
Encore Kba Epo $284 266%
Encore Kba Ppo $355 332%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals