CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ochsner Medical Center-Kenner

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $151
Cash Discount Price: $146
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ochsner Medical Center-Kenner is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $146. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 180 West Esplanade Avenue, Kenner, LA.

Cash / Self-Pay

$146

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $146 (137%)

Insurance Median: $151 (141%)

Cash: $146 (137% of Medicare)

Ins. Median: $151 (141% 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
Medicaid / KanCare	$81 - $86	76%
Humana	$88 - $98	82%
UnitedHealthcare	$88 - $245	82%
Healthy Blue (Healthy Louisiana)	$89	83%
Louisiana Healthcare Connections (Healthy Louisiana)	$89	83%
Aetna	$90 - $423	84%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$90	84%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$95	89%
Blue Cross Blue Shield	$98 - $184	92%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$98	92%
Medicare (plans)	$98	92%
Ochsner Health Plan	$98	92%
Tricare	$98	92%
Wellcare Of Louisiana	$101	95%
Zelis	$287	269%
Healthcomp & Personify Health (Formerly Gilsbar)	$313	293%
Claritev D/B/A Multiplan/Phcs/American Life Care	$337	316%
First Health Network	$391	366%
Louisiana Workers' Compensation Corporation (Lwcc)	$391	366%
Mississippi Physicians Care Network	$391	366%
Galaxy Health Network Ppo	$417	390%
Galaxy Health Network Wc	$417	390%
Employers Health Network (Ehn)	$443	415%
Prime Health Services Ppo	$443	415%
Usa Managed Care Network	$443	415%
Cigna	$453	424%

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 $146.
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 Ochsner Medical Center-Kenner 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.