CMS Price Transparency Data

Ultrasound, pelvis

Facility: Wyandotte Hospital and Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $33
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Wyandotte Hospital and Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.31x the Medicare baseline. Located in 2333 Biddle Ave, Wyandotte, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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%)

Insurance Median: $33 (31%)

Ins. Median: $33 (31% 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
Aetna	$21 - $363	20%
Amerihealth Michigan	$21 - $102	20%
Mclaren Health Plan Inc.	$21 - $32	20%
Meridian	$21 - $32	20%
Molina	$22 - $141	21%
Priority	$22 - $32	21%
Hap	$27 - $113	25%
Humana	$30 - $106	28%
Pace Se Mi	$30	28%
Bcn	$32 - $104	30%
Blue Cross Blue Shield	$32 - $170	30%
Cca Health Mi	$32	30%
Health Alliance Plan Of Michigan	$32	30%
Mount Carmel Health Plan	$32 - $104	30%
United Behavioral Health, Inc.	$32	30%
UnitedHealthcare	$32 - $494	30%
Wellcare Ma	$32	30%
Mclaren	$37	35%
Meridian Health Plan Of Mi	$37 - $135	35%
Priority Health	$37 - $269	35%
Cofinity	$38	36%
Vitalcore Physicians Group Of Mi	$42 - $240	39%
Cigna	$46 - $539	43%
Pace Of Se Mi	$99	93%
Cca Health Michigan	$104	97%
Erickson	$104	97%
Hap Caresource	$104	97%
Mclaren Health	$104 - $339	97%
Molina Mi Health Link	$104	97%
Wellcare	$105	98%
Cofinity Group Health	$243 - $344	228%
Multiplan, Inc.	$507 - $535	475%
University Of Michigan	$606 - $639	567%

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 $X.
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 Wyandotte Hospital and 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.