CMS Price Transparency Data

Ultrasound, pelvis

Facility: Surgical Specialty Center of Baton Rouge

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $139
Cash Discount Price: $428
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Surgical Specialty Center of Baton Rouge is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $428. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.30x the Medicare baseline. Located in 8080 Bluebonnet Blvd, Baton Rouge, LA.

Cash / Self-Pay

$428

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $428 (401%)

Insurance Median: $139 (130%)

Cash: $428 (401% of Medicare)

Ins. Median: $139 (130% 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	$81 - $98	76%
Amerihealth	$81	76%
Healthy_Blue	$81	76%
Humana	$81 - $143	76%
Lhc	$81	76%
Medicaid / KanCare	$81	76%
United_Caid	$81	76%
Coventry	$88	82%
Workcomp_Cov	$88	82%
Cigna	$92	86%
Blue Cross Blue Shield	$95 - $139	89%
Medadv-Peoples	$95	89%
Medicare (plans)	$95	89%
Tricare	$95	89%
UnitedHealthcare	$95	89%
Va	$96	90%
Wellcare	$99	93%
Verity	$108	101%
Lucent	$133	125%
Ehn	$153	143%
Lsufirst	$168	157%
Ambetter / Centene	$198	185%
Workcomp_Saints	$218	204%
Uhc_Commcoffee	$237	222%
United	$245	229%
Gilsbar	$280	262%
Multiplan-Pos	$343	321%
Multiplan-Ppo	$343	321%
Ppoplus	$348	326%
Stjude	$371	347%
Bayou-Med	$400	374%
Dma	$400	374%
Lsu	$400	374%
Southern-Univ	$400	374%
Womans_Hosp	$400	374%
Reny	$428	401%
Workcomp_3R	$463	433%
Three_Rivers	$485	454%
Workcomp_Strat	$485	454%
Geha	$502	470%
Workcomp_Fp	$514	481%
Usa_Mco	$537	503%

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 $428.
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 Surgical Specialty Center of Baton Rouge 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.