CMS Price Transparency Data

Ultrasound, pelvis

Facility: Oakdale Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $519
Cash Discount Price: $179
vs. Medicare Baseline: 4.86x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Oakdale Community Hospital is $519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $179. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.86x the Medicare baseline. Located in 130 N Hospital Dr, Oakdale, LA.

Cash / Self-Pay

$179

Average discount available for prompt cash payment at this facility.

Insurance Median

$519

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: $179 (168%)

Insurance Median: $519 (486%)

Cash: $179 (168% of Medicare)

Ins. Median: $519 (486% 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 486% of the Medicare baseline (a markup of 386%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$111 - $502	104%
Meritain	$111 - $502	104%
Amfirst	$178	167%
Self Pay	$178	167%
Blue Cross Blue Shield	$184	172%
Medicaid / KanCare	$198	185%
UnitedHealthcare	$198	185%
Humana	$217 - $562	203%
Web-Tpa	$446	418%
Cigna	$486 - $503	455%
Ima	$536 - $892	502%
Ppo Plus	$536	502%
Wc Gulf South Risk Srvcs	$803	752%
Wc Martco	$803	752%
Wc Misc	$803	752%
Wc Risk Mgmnt-Baton Rouge	$803	752%
Wc Sedwick Workmans Comp	$803	752%
Wc Us Department Of Labor	$803	752%
American Public Life	$892	835%
American Retirement Life	$892	835%
Apwu	$892	835%
Auto Liability	$892	835%
Bankers Life	$892	835%
Correct Care	$892	835%
Fox Everitt	$892	835%
Mailhandlers Benefit Plan	$892	835%
Medishare	$892	835%
Medplus	$892	835%
Misc Commerical	$892	835%
Phcs	$892	835%
Physicians Mutual	$892	835%
State Farm-La	$892	835%
Triwest	$892	835%
Us Family Health Plan	$892	835%
Usaa	$892	835%

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 $179.
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 Oakdale Community 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.