CMS Price Transparency Data

Ultrasound, pelvis

Facility: Bayou Bend Health System

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $311
Cash Discount Price: $321
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Bayou Bend Health System is $311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.91x the Medicare baseline. Located in 1097 Northwest Blvd, Franklin, LA.

Cash / Self-Pay

$321

Average discount available for prompt cash payment at this facility.

Insurance Median

$311

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: $321 (301%)

Insurance Median: $311 (291%)

Cash: $321 (301% of Medicare)

Ins. Median: $311 (291% 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 291% of the Medicare baseline (a markup of 191%). 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
Blue Cross Blue Shield	$126 - $322	118%
UnitedHealthcare	$179 - $229	168%
Tricare	$206	193%
Aetna	$229 - $311	214%
Dignity Mcr Adv Ip/Op Only-All Plans	$229	214%
Humana	$229 - $298	214%
Sterling Hp Mcr Adv Ip/Op Only-All Plans	$229	214%
Verity Healthnet Mcr Adv Ip/Op Only	$229	214%
Wellcare Mcr Allwell Ip/Op Only-All Plans	$229	214%
Ambetter / Centene	$263	246%
Cigna	$321	301%
Amerihealth Caritas Mcaid Ip/Op Only-All Plans	$322	301%
La Health Mcaid Ip/Op Only	$322	301%
Verity Healthnet Mcaid Ip/Op Only	$322	301%
Diocese Of Lafaytte Ip/Op Only-All Plans	$344	322%
Gilsbar 360 Ip/Op Only-All Plans	$344	322%
Verity Healthnet Ip/Op Only-All Other Plans	$344	322%
Ccn/First Health Ip/Op Only-All Plans	$366	343%
Integrated Hp Multiplan Ip/Op Only-All Plans	$366	343%
Ppo Plus / Zelis Ip/Op Only-All Plans	$366	343%
Geha Ppo Ip/Op Only-All Plans	$389	364%
Usa Mco Ip/Op Only-All Plans	$389	364%
Galaxy Ip/Op Only-All Plans	$412	386%

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 $321.
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 Bayou Bend Health System 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.