CMS Price Transparency Data

Ultrasound, pelvis

Facility: The Women's Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $97
  • Cash Discount Price: $439
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at The Women's Hospital is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $439. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.
Cash / Self-Pay
$439

Average discount available for prompt cash payment at this facility.

Insurance Median
$97

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: $439 (411%)
Insurance Median: $97 (91%)
Cash: $439 (411% of Medicare)
Ins. Median: $97 (91% 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
Aetna $30 - $825 28%
Blue Cross Blue Shield $30 - $359 28%
Caresource $30 - $98 28%
Caresource Hip $30 - $97 28%
Caresource In $30 - $97 28%
Chamber Care $30 - $868 28%
Humana $30 - $285 28%
Iu Health $30 - $620 28%
Mdwise Hip $30 - $97 28%
Meridian Health Il $30 - $98 28%
Mhs $30 - $98 28%
Mhs Behavioral $30 - $97 28%
Molina Il $30 - $98 28%
Molina Ky $30 - $98 28%
Molina Ky Dual $30 - $98 28%
Passport Molina Ky $30 - $285 28%
Patoka Valley Health Care (80/20 Plan) $30 - $768 28%
Patoka Valley Health Care (90/10 Plan) $30 - $744 28%
UnitedHealthcare $30 - $992 28%
Wellcare Ky $30 - $285 28%
Ambetter / Centene $35 - $152 33%
Immergrun $36 - $518 34%
Amish $39 - $118 37%
Caresource Marketplace (Just4Me) $39 - $147 37%
One Care $39 - $868 37%
Hst $41 - $147 38%
Alliance Coal $42 - $859 39%
Allied National/Zelis - Freedom Plan $42 - $240 39%
Claimdoc $44 - $142 41%
Encorecombined $48 - $868 45%
Encoreprime $48 - $843 45%
Hope Trust $48 - $162 45%
Noncontracted $48 - $157 45%
Cigna $53 - $892 50%
Claritev (Formerly Phcs/Mulitplan) $53 - $855 50%
First Health/Coventry $53 - $917 50%
Healthlink $53 - $1,054 50%
Sagamore $53 - $892 50%
Self Pay $79 - $731 74%
Center Care $135 - $967 126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4199 Gateway Blvd, Newburgh, IN 47630
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals