CMS Price Transparency Data

Ultrasound, pelvis

Facility: Rockcastle County Hospital, Inc.

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $176
  • Cash Discount Price: $179
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Rockcastle County Hospital, Inc. is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $179. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.65x the Medicare baseline. Located in 145 Newcomb Avenue, Mount Vernon, KY.
Cash / Self-Pay
$179

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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: $179 (168%)
Insurance Median: $176 (165%)
Cash: $179 (168% of Medicare)
Ins. Median: $176 (165% 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
Passport Hp Hmo - All Plans $50 47%
Caresource Mcaid $71 66%
Coventry Mcaid-All Plans $71 66%
Medicaid / KanCare $71 66%
Molina Mcaid $71 66%
UnitedHealthcare $71 - $350 66%
Tricare $74 69%
Blue Cross Blue Shield $98 - $748 92%
Caresource Mcr Adv-All Other Plans $98 92%
Humana $98 - $322 92%
Molina Marketplace - All Other Plans $98 92%
Molina Mcr Adv $98 92%
Signature Mcr Adv-All Plans $98 92%
Wellcare Mcr Adv-All Other Plans $98 92%
Multiplan-All Plans $187 - $848 175%
Prime Health Services-All Plans $187 - $848 175%
Integrated Hp-All Plans $196 - $888 184%
Corvel - All Plans $198 - $898 185%
Center Care-All Plans $209 - $948 196%
Cigna $213 - $968 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 145 Newcomb Avenue, Mount Vernon, KY 40456
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals