CMS Price Transparency Data

Ultrasound, pelvis

Facility: Covenant Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $100
Cash Discount Price: $851
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Covenant Medical Center is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $851. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.94x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$851

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $851 (797%)

Insurance Median: $100 (94%)

Cash: $851 (797% of Medicare)

Ins. Median: $100 (94% 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
Health Advantage Mclaren Employee	$25 - $733	23%
Priority Health E	$26 - $613	24%
Mclaren Health Advantage	$31 - $599	29%
Physicians Health Plan	$31 - $733	29%
Priority Health	$31 - $733	29%
Aetna	$32 - $979	30%
Blue Cross Blue Shield	$32 - $167	30%
Health Alliance Plan Of Michigan	$32 - $206	30%
Healthy Michigan Mclaren	$32 - $99	30%
Healthy Michigan Meridian	$32 - $99	30%
Healthy Michigan Molina	$32 - $99	30%
Healthy Michigan Priority Health	$32 - $99	30%
Humana	$32 - $999	30%
Mclaren Advantage	$32 - $107	30%
Molina Healthplan	$32 - $107	30%
Physicians Health Plan Advantage/Advantage Plus	$32 - $107	30%
Meritain Health	$43 - $1,019	40%
Multiplan	$50 - $1,199	47%
Blue Care Network	$52 - $167	49%
Cigna	$669 - $733	626%

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 $851.
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 Covenant Medical Center 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.