CMS Price Transparency Data

Ultrasound, pelvis

Facility: University of Louisville Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $301
Cash Discount Price: $206
vs. Medicare Baseline: 2.82x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at University of Louisville Hospital is $301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.82x the Medicare baseline. Located in 530 South Jackson Street, Louisville, KY.

Cash / Self-Pay

$206

Average discount available for prompt cash payment at this facility.

Insurance Median

$301

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: $206 (193%)

Insurance Median: $301 (282%)

Cash: $206 (193% of Medicare)

Ins. Median: $301 (282% 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 282% of the Medicare baseline (a markup of 182%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Blue Cross Blue Shield	$65 - $1,317	61%
Aetna	$68 - $222	64%
Humana	$68 - $222	64%
UnitedHealthcare	$68 - $628	64%
Passport	$70 - $658	66%
Senior Care Community Of Ky	$96	90%
Cigna	$100	94%
Essence Health	$100	94%
Va Ccn	$100	94%
Signature	$103 - $658	96%
Communicare	$105	98%
Devoted	$105 - $395	98%
Prime Group Health	$111 - $1,119	104%
Wellcare	$116 - $135	109%
Velocity	$120 - $1,291	112%
Key Benefit Administrators	$130	122%
Cshn	$261 - $1,317	244%
Multiplan	$265 - $1,185	248%
Encore	$281 - $922	263%
Health Smart	$301 - $988	282%
Omca	$381 - $1,251	357%
Corvel	$401 - $1,317	375%
National Comp Care	$401 - $1,317	375%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $206.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Louisville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.