CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ochsner Lafayette General Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $92
Cash Discount Price: $149
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ochsner Lafayette General Medical Center is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.86x the Medicare baseline. Located in 1214 Coolidge Avenue, Lafayette, LA.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $149 (140%)

Insurance Median: $92 (86%)

Cash: $149 (140% of Medicare)

Ins. Median: $92 (86% 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.

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
Verity Commercial And First Choice Network	$42 - $383	39%
UnitedHealthcare	$65 - $122	61%
Cigna	$69 - $311	65%
Aetna	$73 - $388	68%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$73 - $87	68%
Healthy Blue (Healthy Louisiana)	$73 - $87	68%
Humana	$73 - $97	68%
Louisiana Healthcare Connections (Healthy Louisiana)	$73 - $87	68%
Zelis	$73 - $425	68%
Blue Cross Blue Shield	$92 - $213	86%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$92 - $97	86%
Medicare (plans)	$92 - $97	86%
Ochsner Health Plan	$92 - $97	86%
Wellcare Of Louisiana	$92 - $102	86%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$95 - $100	89%
Tricare	$96 - $97	90%

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 $149.
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 Ochsner Lafayette General Medical Center 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.