CMS Price Transparency Data

Ultrasound, pelvis

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $107
  • Cash Discount Price: $702
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Munson Healthcare Otsego Memorial Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $702. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.
Cash / Self-Pay
$702

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $702 (657%)
Insurance Median: $107 (100%)
Cash: $702 (657% of Medicare)
Ins. Median: $107 (100% 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.

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 $21 - $516 20%
Mclaren Health Plan $21 - $693 20%
Meridian $21 - $54 20%
Molina $21 - $112 20%
Priority Health $21 - $248 20%
UnitedHealthcare $21 - $662 20%
Aetna $32 - $670 30%
Blue Care Network $32 - $104 30%
Hap (Health Alliance Plan) $32 - $662 30%
Humana $32 - $104 30%
Medicare (plans) $32 - $104 30%
Michigan Amish Medical Board $32 - $104 30%
Northern Michigan Mennonite Group $32 - $104 30%
Asr Physicians Care Network $48 - $662 45%
Cigna $49 - $248 46%
Nomi Health $51 - $662 48%
Employee Benefit Logistics $54 - $177 51%
Hospice Of Michigan $495 - $496 463%
Munson Hospice $578 - $852 541%
Enterprise Group Planning/Employee Benefit Plan $660 - $662 618%
Cofinity $701 - $703 656%
Provider Network Of America/Hawaii Mainland Administrative Group Health $701 - $703 656%
Three Rivers Provider Network $701 - $703 656%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 825 N Center Ave, Gaylord, MI 49735
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals