CMS Price Transparency Data

Ultrasound, pelvis

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $133
Cash Discount Price: $2,530
vs. Medicare Baseline: 1.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at UMass Memorial Health - Harrington Hospital is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,530. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$2,530

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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: $2,530 (2369%)

Insurance Median: $133 (125%)

Cash: $2,530 (2369% of Medicare)

Ins. Median: $133 (125% 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
Masshealth [20302]	$16	15%
Medicaid / KanCare	$16 - $765	15%
Workers Compensation [20501]	$97	91%
Champva [11001]	$126	118%
Cigna	$127 - $1,136	119%
Institution [10406]	$127	119%
Mgb Mcr [10124]	$127	119%
Tufts Us Family [11203]	$127	119%
Blue Cross Blue Shield	$131 - $207	123%
Aetna	$133 - $1,471	125%
Commonwealth Care Alliance [10103]	$133	125%
Fallon Mcr Supp [20202]	$133	125%
Fallon Mcr [10105]	$133	125%
Tufts Mcr [10112]	$133	125%
UnitedHealthcare	$133 - $1,471	125%
Senior Whole Health [10110]	$136	127%
Wellpoint [11112]	$198	185%
Tufts Connectorcare [10507]	$216	202%
Hsno/Free Care [10801]	$681	638%
Hne [11108]	$957	896%
First Health Network [11120]	$1,103	1033%
Evernorth Behavioral Health [27]	$1,177	1102%
Connecticare [11105]	$1,471	1377%
Fallon Carelon Hlth [28]	$1,471	1377%
Fallon Mcaid Carelon Hlth [29]	$1,471	1377%
Grants [20507]	$1,471	1377%
Masshealth Mcd Mbhp [38]	$1,471	1377%
Wellsense Mcaid Carelon Hlth [21]	$1,471	1377%

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 $2,530.
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 UMass Memorial Health - Harrington 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.