CMS Price Transparency Data

Ultrasound, pelvis

Facility: Insight Hospital and Medical Center Coldwater

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $646
  • Cash Discount Price: $738
  • vs. Medicare Baseline: 6.05x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Insight Hospital and Medical Center Coldwater is $646. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $738. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.05x the Medicare baseline. Located in 274 E Chicago St, Coldwater, MI.
Cash / Self-Pay
$738

Average discount available for prompt cash payment at this facility.

Insurance Median
$646

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: $738 (691%)
Insurance Median: $646 (605%)
Cash: $738 (691% of Medicare)
Ins. Median: $646 (605% 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 605% of the Medicare baseline (a markup of 505%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $646 605%
Blue Cross Blue Shield $646 605%
Cofinity $646 605%
Frontpath $646 605%
Hap $646 605%
Health Alliance Plan $646 605%
Humana $646 605%
Mclaren $646 605%
Medicaid / KanCare $646 605%
Medicare (plans) $646 605%
Multi-Plan $646 605%
Paramount Elite $646 605%
Paramount Hmo $646 605%
Paramount Ppo $646 605%
Phcs $646 605%
Php Northern Indiana $646 605%
Php Of Mid Michigan $646 605%
Priority $646 605%
UnitedHealthcare $646 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 274 E Chicago St, Coldwater, MI 49036
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals