CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ochsner St Mary

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $97
Cash Discount Price: $94
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ochsner St Mary is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 1125 Marguerite Street, Morgan City, LA.

Cash / Self-Pay

$94

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: $94 (88%)

Insurance Median: $97 (91%)

Cash: $94 (88% 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.

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
Tricare	$41 - $104	38%
Healthy Blue (Healthy Louisiana)	$60	56%
Humana	$60 - $97	56%
Louisiana Healthcare Connections (Healthy Louisiana)	$60	56%
UnitedHealthcare	$60 - $250	56%
Aetna	$61 - $401	57%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$61	57%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$97	91%
Blue Cross Blue Shield	$97 - $175	91%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$97	91%
Medicare (plans)	$97	91%
Ochsner Health Plan	$97	91%
Zelis	$146	137%
Verity Commercial And First Choice Network	$254	238%
Claritev D/B/A Multiplan/Phcs/American Life Care	$273	256%
First Health Network	$315	295%
Healthcomp & Personify Health (Formerly Gilsbar)	$329	308%
Cigna	$356	333%

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 $94.
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 St Mary 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.