CMS Price Transparency Data
Ultrasound, pelvis
Facility: Avoyelles Hospital
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $550
- Cash Discount Price: $256
- vs. Medicare Baseline: 5.15x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Avoyelles Hospital is $550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $256. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.15x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$256
Average discount available for prompt cash payment at this facility.
Insurance Median
$550
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: $256 (240%)
Insurance Median: $550 (515%)
Cash: $256 (240% of Medicare)
Ins. Median: $550 (515% 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 515% of the Medicare baseline (a markup of 415%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $111 - $650 | 104% |
| Amer Contl Ins | $111 - $650 | 104% |
| Coventry | $111 - $650 | 104% |
| First Choice Health | $111 - $650 | 104% |
| Meritan Health | $111 - $1,157 | 104% |
| Cigna | $114 - $653 | 107% |
| Correct Cr Int Hlt | $114 - $241 | 107% |
| Mcd Amerihealth Caritas | $114 - $241 | 107% |
| Mcd Healthy Blue | $114 - $241 | 107% |
| Mcd La Hc Conn | $114 - $241 | 107% |
| Medicaid / KanCare | $114 - $241 | 107% |
| UnitedHealthcare | $114 - $241 | 107% |
| Mcd Ms | $126 - $265 | 118% |
| Student Assurances | $165 - $1,157 | 154% |
| Blue Cross Blue Shield | $176 | 165% |
| Ofc Of Grp Bene | $176 | 165% |
| Humana | $198 - $656 | 185% |
| Ppo Plus Llc | $330 - $694 | 309% |
| Zelis Healthcare Bpa | $330 - $694 | 309% |
| Gilsbar | $346 - $729 | 324% |
| Amerind | $495 - $1,041 | 463% |
| Applied Underwriters | $495 - $1,041 | 463% |
| Sedgwick | $495 - $1,041 | 463% |
| Us Dept Of Labor | $495 - $1,041 | 463% |
| Wc Clms Admin Svcs | $495 - $1,041 | 463% |
| Wc Clms Mgmnt Walmart | $495 - $1,041 | 463% |
| Wc Esis | $495 - $1,041 | 463% |
| Wc Fara | $495 - $1,041 | 463% |
| Wc Gallagher Bassett | $495 - $1,041 | 463% |
| Wc Guide One | $495 - $1,041 | 463% |
| Wc Hartford Med | $495 - $1,041 | 463% |
| Wc Luba | $495 - $1,041 | 463% |
| Wc Lwcc | $495 - $1,041 | 463% |
| Wc Paragon Casino Resort | $495 - $1,041 | 463% |
| Wc Risk Mgmnt | $495 - $1,041 | 463% |
| Wc Stone Trust | $495 - $1,041 | 463% |
| Wc Summit Consulting Hold | $495 - $1,041 | 463% |
| Wc Travelers Ins | $495 - $1,041 | 463% |
| Wc Trs Workers Comp Claim | $495 - $1,041 | 463% |
| Wc Us Dol | $495 - $1,041 | 463% |
| Wc Zurich | $495 - $1,041 | 463% |
| Aarp | $550 - $1,157 | 515% |
| Admin Concepts | $550 - $1,157 | 515% |
| All Saints Hospice | $550 - $1,157 | 515% |
| All State | $550 - $1,157 | 515% |
| Allegiance Health Hospice | $550 - $1,157 | 515% |
| Allied Natl | $550 - $1,157 | 515% |
| Amfirst | $550 - $1,157 | 515% |
| Avoy Parish School Board | $550 - $1,157 | 515% |
| Avoyelles Parish Sheriff | $550 - $1,157 | 515% |
| Bollinger | $550 - $1,157 | 515% |
| Ccmsi | $550 - $1,157 | 515% |
| Central States | $550 - $1,157 | 515% |
| Christus Health Plan | $550 - $1,157 | 515% |
| Compassionate Care Hospic | $550 - $1,157 | 515% |
| Core Source | $550 - $1,157 | 515% |
| Coushatta Hlth Dept | $550 - $1,157 | 515% |
| Ebms | $550 - $1,157 | 515% |
| Federated Ins | $550 - $1,157 | 515% |
| Feedom Life | $550 - $1,157 | 515% |
| Fidelity Standard Life Co | $550 - $1,157 | 515% |
| Fox Everette | $550 - $1,157 | 515% |
| Guarantee Trust | $550 - $1,157 | 515% |
| Heart Of Hospice | $550 - $1,157 | 515% |
| Hos Christus Hospice | $550 - $1,157 | 515% |
| Hos Guardian Hospice Care | $550 - $1,157 | 515% |
| Hos Harbor Hospice Alex | $550 - $1,157 | 515% |
| Hos La Hospice Palliative | $550 - $1,157 | 515% |
| Hos Passages Hospice N. | $550 - $1,157 | 515% |
| Hos St Joseph Hospice | $550 - $1,157 | 515% |
| Hospice Miscellaneous | $550 - $1,157 | 515% |
| Ins Mgmnt Admin | $550 - $1,157 | 515% |
| Ins Tpa | $550 - $1,157 | 515% |
| Liberty Health Share | $550 - $1,157 | 515% |
| Lumico | $550 - $1,157 | 515% |
| Manhattan Life Ins | $550 - $1,157 | 515% |
| Medi Share | $550 - $1,157 | 515% |
| Misc Comm | $550 - $1,157 | 515% |
| Nalc | $550 - $1,157 | 515% |
| New Era Life | $550 - $1,157 | 515% |
| North American | $550 - $1,157 | 515% |
| Phcs | $550 - $1,157 | 515% |
| Physicians Mutual | $550 - $1,157 | 515% |
| Pipeline Ind Bene | $550 - $1,157 | 515% |
| Progressive Auto | $550 - $1,157 | 515% |
| Reliance Standard Life | $550 - $1,157 | 515% |
| Rural Carriers | $550 - $1,157 | 515% |
| Shelter Ins Co | $550 - $1,157 | 515% |
| Sierre Health And Life | $550 - $1,157 | 515% |
| State Farm | $550 - $1,157 | 515% |
| State Mutual | $550 - $1,157 | 515% |
| Sterling Investors | $550 - $1,157 | 515% |
| The Health Plan | $550 - $1,157 | 515% |
| Tribal Hlth Partners | $550 - $1,157 | 515% |
| Tricare | $550 - $1,157 | 515% |
| Trustmark Health Benefits | $550 - $1,157 | 515% |
| Tunica Biloxi | $550 - $1,157 | 515% |
| Uct | $550 - $1,157 | 515% |
| Unified Life | $550 - $1,157 | 515% |
| Usaa Life Ins | $550 - $1,157 | 515% |
| Web-Tpa | $550 - $1,157 | 515% |
| Woodmen Of The World | $550 - $1,157 | 515% |