CMS Price Transparency Data

Ultrasound, pelvis

Facility: Sanford Canby Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $838
  • Cash Discount Price: $819
  • vs. Medicare Baseline: 7.85x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Sanford Canby Medical Center is $838. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $819. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.85x the Medicare baseline. Located in 112 St Olaf Avenue South, Canby, MN.
Cash / Self-Pay
$819

Average discount available for prompt cash payment at this facility.

Insurance Median
$838

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: $819 (767%)
Insurance Median: $838 (785%)
Cash: $819 (767% of Medicare)
Ins. Median: $838 (785% 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 785% of the Medicare baseline (a markup of 685%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Ucare $112 - $900 105%
Blue Cross Blue Shield $248 - $838 232%
Sanford Health Plan Align $467 437%
Aetna $506 - $890 474%
Health Partners $506 - $819 474%
Medicare (plans) $506 474%
UnitedHealthcare $506 - $855 474%
Primewest $516 - $563 483%
Security Health Plan $563 527%
Sanford Health Plan $808 - $951 756%
Medica $900 - $969 843%
Cigna $922 863%
First Choice Health Network $922 863%
Healthez $922 863%
Multiplan $922 863%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 112 St Olaf Avenue South, Canby, MN 56220
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals