CMS Price Transparency Data

Ultrasound, pelvis

Facility: North Oaks Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $97
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 0.91x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at North Oaks Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 15790 Paul Vega Md Drive, Hammond, LA.
Cash / Self-Pay
$249

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: $249 (233%)
Insurance Median: $97 (91%)
Cash: $249 (233% 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.

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 $91 - $97 85%
Mco Lhc $93 87%
Aetna $95 - $1,119 89%
Humana $95 - $987 89%
Mco Hb $95 89%
Mco Lacare Am $95 89%
Medicaid / KanCare $95 89%
UnitedHealthcare $95 - $632 89%
Allwell $97 91%
Blue Advantage $97 91%
Champva $97 91%
Healthy Blue Dual Advantage $97 91%
Peoples Health $97 91%
Vantage 65 $97 91%
Veterans Administration $97 91%
Wellcare $97 91%
Blue Cross Blue Shield $246 - $249 230%
Coventry $855 800%
Verity Healthnet $855 800%
Ppoplus Llc $921 862%
Multiplan $987 924%
Cigna $1,040 974%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15790 Paul Vega Md Drive, Hammond, LA 70403
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals