CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,280
Cash Discount Price: $427
vs. Medicare Baseline: 11.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Regional Medical Center is $1,280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.98x the Medicare baseline. Located in 800 E Main, Ville Platte, LA.

Cash / Self-Pay

$427

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,280

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: $427 (400%)

Insurance Median: $1,280 (1198%)

Cash: $427 (400% of Medicare)

Ins. Median: $1,280 (1198% 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 1198% of the Medicare baseline (a markup of 1098%). 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
Pp0/Manged Care	$80 - $1,422	75%
Ppo/Manged Care	$80 - $1,422	75%
Aetna	$172	161%
Mcd Hmo Amerigroup	$172	161%
Mcd Hmo La Care	$172	161%
Mcd Hmo La Hlth Cr Connct	$172	161%
Medicaid / KanCare	$172 - $1,422	161%
UnitedHealthcare	$174	163%
Mcd Hmo Com Hlth Solution	$189	177%
Blue Cross Blue Shield	$216	202%
Charity/Map	$427 - $1,422	400%
American Postal Workers	$1,138	1065%
Work Comp	$1,280	1198%
Commerical	$1,422	1331%
Commerical Ip	$1,422	1331%
Mcr American Hlth Adv	$1,422	1331%
Medicare (plans)	$1,422	1331%
Mra Auto/Liability	$1,422	1331%
Tricare	$1,422	1331%

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 $427.
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 Mercy Regional Medical Center 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.