CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lake Charles Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $127
Cash Discount Price: $462
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lake Charles Memorial Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $462. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.19x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.

Cash / Self-Pay

$462

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $462 (433%)

Insurance Median: $127 (119%)

Cash: $462 (433% of Medicare)

Ins. Median: $127 (119% 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
Aetna	$97 - $344	91%
Blue Cross Blue Shield	$97	91%
Champus_Va	$97	91%
Cigna	$97 - $578	91%
Medicare (plans)	$97	91%
Tricare	$97	91%
Veterans_Administration	$97	91%
Veterans_Choice-Triwest	$97	91%
Humana	$99 - $340	93%
Medicaid / KanCare	$121 - $133	113%
Coushatta_Tribe_Dept_Of_Health	$175	164%
Vantage_Commercial	$223	209%
Blue_Cross_Blue_Shield_La	$233	218%
Meritain	$347	325%
Verity	$370	346%
United_Healthcare	$446	418%
Ppo_Plus_	$462	433%
Phcs	$539	505%
United_Healthcare_Behavorial_Health	$539	505%
Lwcc	$589	551%
First_Health	$616	577%
Workers_Compensation	$693	649%

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 $462.
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 Lake Charles Memorial 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.