CMS Price Transparency Data

Ultrasound, pelvis

Facility: Munson Healthcare Manistee Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $100
Cash Discount Price: $313
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Munson Healthcare Manistee Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $313. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.94x the Medicare baseline. Located in 1465 E Parkdale Ave, Manistee, MI.

Cash / Self-Pay

$313

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: $313 (293%)

Insurance Median: $100 (94%)

Cash: $313 (293% 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
Blue Cross Blue Shield	$21 - $185	20%
Mclaren Health Plan	$21 - $276	20%
Meridian	$21 - $54	20%
Molina	$21 - $112	20%
Priority Health	$21 - $248	20%
UnitedHealthcare	$21 - $331	20%
Aetna	$32 - $318	30%
Hap (Health Alliance Plan)	$32 - $294	30%
Humana	$32 - $104	30%
Medicare (plans)	$32 - $104	30%
Michigan Amish Medical Board	$32 - $104	30%
Northern Michigan Mennonite Group	$32 - $104	30%
Prime Health Services	$32 - $339	30%
Wellcare Meridian	$32 - $104	30%
Cofinity	$43 - $324	40%
Provider Network Of America	$45 - $313	42%
Asr/Physicians Care	$48 - $294	45%
Cigna	$49 - $248	46%
Nomi Health	$51 - $294	48%
Employee Benefits Logistics	$54 - $177	51%
Hospice Of Michigan	$221	207%
Munson Hospice	$258 - $852	242%
Enterprise Group Planning/Employee Benefits Plan	$294	275%
Medical Cost Savings Solution	$294	275%
Three Rivers Provider Network	$313	293%
Multiplan	$324	303%
Great West Healthcare	$331	310%

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 $313.
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 Munson Healthcare Manistee 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.