CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Hospital Lebanon

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,010
Cash Discount Price: $875
vs. Medicare Baseline: 9.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Lebanon is $1,010. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $875. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.46x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.

Cash / Self-Pay

$875

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,010

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: $875 (819%)

Insurance Median: $1,010 (946%)

Cash: $875 (819% of Medicare)

Ins. Median: $1,010 (946% 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 946% of the Medicare baseline (a markup of 846%). 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	$60 - $242	56%
Medicare (plans)	$97 - $103	91%
Aetna	$101 - $1,010	95%
Blue Cross Blue Shield	$101 - $733	95%
Champva [20065]	$101	95%
Cherokee Nation Health Serv Contracted [320066]	$101	95%
Cigna	$101 - $996	95%
Cross Timbers Hospice [20098]	$101	95%
Dept Of Veteran Affairs Contracted [320106]	$101	95%
Elara Caring Aspire Hospice [20433]	$101	95%
Globalhealth Contracted [320145]	$101	95%
Halo Hcr Inc Hospice Contracted [320432]	$101	95%
Halo Hcr Inc Hospice [20432]	$101	95%
Humana	$101 - $1,144	95%
Kindful Hospice Contracted [320434]	$101	95%
Kindful Hospice [20434]	$101	95%
Mercy Hospice Okc [20252]	$101	95%
Mercy Mgd Behavioral Health Contracted [320259]	$101	95%
Pace Of The Ozarks Contracted [320518]	$101	95%
Provider Partners Health Plans Contracted [320450]	$101	95%
Qual Choice Contracted [320325]	$101	95%
Tricare	$101	95%
UnitedHealthcare	$101 - $1,279	95%
Healthscope Contracted [320182]	$129	121%
Centivo Contracted [320505]	$170	159%
Ambetter / Centene	$242	227%
Home State Health Plan Contracted [320187]	$242	227%
Novasys Contracted [320285]	$242	227%
Medica Contracted [320239]	$532	498%
Medica [20239]	$532	498%
Administrative Payor Contracted [320005]	$606	567%
Healthlink Contracted [320179]	$875 - $1,144	819%
Preferred Health Plan Contracted [320522]	$875	819%
90 Degree Benefits Contracted [320436]	$1,010	946%
Mercy Benefit Admin Contracted [320251]	$1,010 - $1,077	946%
Show-Me Health Administrators Contracted [320483]	$1,010	946%
United Medical Resources Contracted [320454]	$1,010 - $1,077	946%
Aither Health Contracted [320449]	$1,077	1008%
Auxiant Contracted [320462]	$1,077	1008%
Benefit Management Contracted [320052]	$1,077	1008%
Ebms Contracted [320493]	$1,077	1008%
Edison Health Solutions Contracted [320502]	$1,077	1008%
Evolutions Health Care Contracted [320124]	$1,077	1008%
First Health Contracted [320128]	$1,077	1008%
Health Systems Inc Contracted [320174]	$1,077	1008%
Imagine 360 Contracted [320494]	$1,077	1008%
Insurance System Inc Contracted [320465]	$1,077	1008%
Point C Contracted [320238]	$1,077 - $1,279	1008%
Point C [20238]	$1,077	1008%
Reflect Health Contracted [320492]	$1,077	1008%
Workers Comp [20426]	$1,077 - $1,144	1008%
Yuzu Health Contracted [320521]	$1,077	1008%
American Healthcare Alliance Contracted [320020]	$1,144	1071%
Usa Managed Care Org Contracted [320429]	$1,184	1109%
Multiplan Contracted [320270]	$1,279	1197%
Private Health Care Systems Contracted [320320]	$1,279	1197%

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 $875.
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 Mercy Hospital Lebanon 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.