CMS Price Transparency Data

Ultrasound, pelvis

Facility: Northeast Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,189
  • Cash Discount Price: $1,320
  • vs. Medicare Baseline: 11.13x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Northeast Regional Medical Center is $1,189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,320. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.13x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$1,320

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,189

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: $1,320 (1236%)
Insurance Median: $1,189 (1113%)
Cash: $1,320 (1236% of Medicare)
Ins. Median: $1,189 (1113% 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 1113% of the Medicare baseline (a markup of 1013%). 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
Medicaid / KanCare $91 - $148 85%
Veterans Eval Services $92 86%
Node Champva $106 99%
Tricare $106 99%
Medicare (plans) $110 103%
Node Hospice Non Par Agree $112 105%
Node Va $112 105%
UnitedHealthcare $112 - $2,505 105%
Blue Cross Blue Shield $113 - $1,019 106%
Node Devoted Health Mcr Adv $116 109%
Blue Pathway/Pathway X $129 121%
Centurion Correctional $140 131%
Us Department Of Labor $140 131%
Home State Exchange $202 189%
Naphcare $213 199%
Immergrun $224 210%
Blue Prefrerred $269 252%
Blue Access $278 260%
Self Pay $802 - $1,837 751%
Cigna $1,136 - $1,306 1064%
Aetna $1,243 - $2,786 1164%
Access Health Services, Llc $2,171 2033%
Healthlink $2,505 - $2,672 2345%
Multiplan $2,505 - $2,672 2345%
Coventry Wc $2,672 2502%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals