CMS Price Transparency Data

Ultrasound, pelvis

Facility: Centerpoint Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,105
Cash Discount Price: $5,405
vs. Medicare Baseline: 10.35x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Centerpoint Medical Center is $1,105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,405. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.35x the Medicare baseline. Located in 19600 East 39Th Street, Independence, MO.

Cash / Self-Pay

$5,405

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,105

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: $5,405 (5060%)

Insurance Median: $1,105 (1035%)

Cash: $5,405 (5060% of Medicare)

Ins. Median: $1,105 (1035% 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 1035% of the Medicare baseline (a markup of 935%). 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
Global Sports Services	$25	23%
United	$60 - $2,486	56%
Healthyblue	$61	57%
Amerigroup	$62	58%
Medicaid / KanCare	$62	58%
Unicare	$62	58%
Home State Health Plan	$63	59%
Aetna	$97 - $2,818	91%
Multiplan	$100 - $4,089	94%
Corvel Corporation	$119 - $3,591	111%
Cigna	$122 - $4,420	114%
Oha Network	$124 - $2,763	116%
Blue Cross Blue Shield	$164 - $2,542	154%
Humana	$164 - $212	154%
Ambetter / Centene	$983 - $1,028	920%
Nhc Advantage	$1,004 - $1,050	940%
Wppa Providrs Care Network	$1,057 - $1,105	990%
Universal Healthcare	$1,850 - $1,934	1732%
Coventry	$2,125 - $2,221	1990%
Coventry Kc Mo	$2,167 - $2,265	2029%
College Park Family Care Center	$2,273 - $2,376	2128%
Cco, Inc.	$4,492 - $4,696	4206%
Focus Healthcare Mgmt, Inc	$4,756 - $4,973	4453%

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 $5,405.
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 Centerpoint Medical Center 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.