CMS Price Transparency Data

Ultrasound, pelvis

Facility: Dukes Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $194
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 1.82x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Dukes Memorial Hospital is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.82x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$194

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: $198 (185%)
Insurance Median: $194 (182%)
Cash: $198 (185% of Medicare)
Ins. Median: $194 (182% 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
Department Of Veterans Affairs $48 - $290 45%
Tricare $48 - $290 45%
Blue Cross Blue Shield $51 - $501 48%
Humana $51 - $308 48%
Iu Health Plan $51 - $308 48%
Managed Health Services $51 - $626 48%
Medicare (plans) $51 - $308 48%
UnitedHealthcare $51 - $770 48%
Aetna $52 - $745 49%
Node Devoted Health Mcr Adv $52 - $314 49%
Node Va $52 - $756 49%
In Dept Of Correction $54 - $326 51%
Miami County Sheriffs Department $54 - $326 51%
Node Pphp Mcr Adv $54 - $329 51%
Lutheran Advanced Network $77 - $470 72%
Lutheran Three Rivers Preferred Plus 150 $77 - $470 72%
Node Lutheran Preferred Fixed 2 $77 - $470 72%
Lutheran Preferred $82 - $1,253 77%
Align Network $83 - $501 78%
Lutheran Three Rivers Preferred Plus 175 $90 - $548 84%
Encore Work Comp In $93 - $564 87%
Prime Health Services $93 - $1,174 87%
One Call Wc $98 92%
Partners Direct Health Llc $98 - $595 92%
Veterans Eval Services $98 92%
Lutheran Northwest Health Preferred $103 - $626 96%
Three Rivers Preferred Plus $103 - $626 96%
Work Comp $103 - $626 96%
Physicians Health Plan $104 - $730 97%
Cigna $109 - $1,566 102%
Three Rivers Preferred $116 - $705 109%
Php Freedom $119 - $723 111%
Encore Kba Epo $124 - $752 116%
Amish Aid $129 - $783 121%
Encore Ppo $129 - $783 121%
Self Pay $129 - $861 121%
Sagamore Health Network $143 - $868 134%
Encore Kba Ppo $155 - $940 145%
Consumer Life $160 - $971 150%
Us Department Of Labor $165 154%
Caresource $189 - $245 177%
First Health $206 - $1,253 193%
Multiplan $209 - $1,268 196%
Encore Health Network $212 - $1,284 198%
Advantage Health Solutions $214 - $1,300 200%
Encore $232 - $1,409 217%
Medicaid / KanCare $245 229%
Mhs $245 229%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 W 12Th St, Peru, IN 46970
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals