CMS Price Transparency Data

Ultrasound, pelvis

Facility: Owatonna Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $432
Cash Discount Price: $407
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Owatonna Hospital is $432. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.04x the Medicare baseline. Located in 2250 26Th Street Northwest, Owatonna, MN.

Cash / Self-Pay

$407

Average discount available for prompt cash payment at this facility.

Insurance Median

$432

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: $407 (381%)

Insurance Median: $432 (404%)

Cash: $407 (381% of Medicare)

Ins. Median: $432 (404% 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 404% of the Medicare baseline (a markup of 304%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$100	94%
Aetna	$102 - $540	95%
Medicare (plans)	$107 - $108	100%
South Country Health Alliance	$108	101%
Ucare Pmap (A B C D E G N O S U R H)	$110 - $183	103%
Medica	$111 - $519	104%
Blue Cross Blue Shield	$112 - $493	105%
Medica Health System	$286 - $546	268%
Healthpartners	$369 - $615	345%
Medica Ubh (O)	$381 - $763	357%
Health Partners	$402 - $670	376%
Americas Ppo (Araz)(B D N O R S V)	$420 - $701	393%
Medica Ubh Pmap	$436 - $727	408%
Americas Ppo (Araz) (B D N H O R S)	$458 - $763	429%
First Health (A C E G H U B D N O R S)	$458 - $763	429%
Medica Mhps	$519	486%
All Other Contracted Care (A B C D E G H N O R S U)	$545 - $908	510%
UnitedHealthcare	$625	585%

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 $407.
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 Owatonna 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.