CMS Price Transparency Data

Ultrasound, pelvis

Facility: Perham Health

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $321
  • Cash Discount Price: $579
  • vs. Medicare Baseline: 3.01x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Perham Health is $321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $579. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.01x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.
Cash / Self-Pay
$579

Average discount available for prompt cash payment at this facility.

Insurance Median
$321

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: $579 (542%)
Insurance Median: $321 (301%)
Cash: $579 (542% of Medicare)
Ins. Median: $321 (301% 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 301% of the Medicare baseline (a markup of 201%). 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.

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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 $247 - $602 231%
Health Partners Mcr Adv $303 284%
Humana $303 284%
Medica Mcr Adv $303 284%
Medicare (plans) $303 - $336 284%
Ucare Mn Senior Health Options $303 284%
UnitedHealthcare $312 - $694 292%
Ucare Mn Special Needs Basic Care Dual $318 298%
Ucare Mn Medical Assistance $320 300%
Ucare Mn Minnesota Care $320 300%
Ucare Mn Senior Care Plus $320 300%
Ucare Mn Special Needs Basic Care $320 300%
Medicaid / KanCare $321 301%
Medica Mcaid Mn Care $326 305%
Medica Mn (Msho) $367 344%
Ucare Individual And Family Plan-All Other Plans $368 345%
Medica Mn Senior Hp/Outside Mn $405 379%
Health Partners Minnesota Care $445 417%
Medica Commercial-All Other Plans $651 609%
Preferred One (Pchp, Pic, Pas)-All Other Plans $668 625%
Health Partners-All Plans $730 683%
Preferred One (Ppo) $756 708%
Sanford Health Plan-All Plans $756 708%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Coney Street West, Perham, MN 56573
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals