CMS Price Transparency Data
Ultrasound, pelvis
Facility: Mercy Hospital Lincoln
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $126
- Cash Discount Price: $355
- vs. Medicare Baseline: 1.18x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Lincoln is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $355. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.18x the Medicare baseline. Located in 1000 East Cherry Street, Troy, MO.
Cash / Self-Pay
$355
Average discount available for prompt cash payment at this facility.
Insurance Median
$126
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: $355 (332%)
Insurance Median: $126 (118%)
Cash: $355 (332% of Medicare)
Ins. Median: $126 (118% 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.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Aetna | $21 - $624 | 20% |
| Medicaid / KanCare | $21 - $437 | 20% |
| Medicare (plans) | $30 - $953 | 28% |
| Tricare | $30 - $204 | 28% |
| UnitedHealthcare | $31 - $629 | 29% |
| American Health Advantage Of Mo Mcr [10473] | $33 - $224 | 31% |
| Blue Cross Blue Shield | $33 - $734 | 31% |
| Cherokee Nation Health Serv Contracted [320066] | $33 - $224 | 31% |
| Cross Timbers Hospice [20098] | $33 - $224 | 31% |
| Dept Of Veteran Affairs Contracted [320106] | $33 - $224 | 31% |
| Elara Caring Aspire Hospice Contracted [320433] | $33 - $224 | 31% |
| Elara Caring Aspire Hospice [20433] | $33 - $224 | 31% |
| Globalhealth Contracted [320145] | $33 - $224 | 31% |
| Halo Hcr Inc Hospice Contracted [320432] | $33 - $224 | 31% |
| Halo Hcr Inc Hospice [20432] | $33 - $224 | 31% |
| Humana | $33 - $858 | 31% |
| Indian Health Service Contracted [320198] | $33 - $224 | 31% |
| Kindful Hospice Contracted [320434] | $33 - $224 | 31% |
| Kindful Hospice [20434] | $33 - $224 | 31% |
| Mercy Hospice Okc [20252] | $33 - $224 | 31% |
| Pace Of The Ozarks Contracted [320518] | $33 - $224 | 31% |
| Provider Partners Health Plans Contracted [320450] | $33 - $223 | 31% |
| Qual Choice Contracted [320325] | $33 - $224 | 31% |
| Cigna | $35 - $239 | 33% |
| Centivo Contracted [320505] | $51 - $346 | 48% |
| Medica Contracted [320239] | $59 - $400 | 55% |
| Ambetter / Centene | $64 - $437 | 60% |
| Home State Health Plan Contracted [320187] | $64 - $437 | 60% |
| Novasys Contracted [320285] | $64 - $437 | 60% |
| Hope Trust Contracted [320488] | $69 - $472 | 65% |
| Health Choices Contracted [320448] | $84 - $572 | 79% |
| Health Choices [20448] | $84 - $572 | 79% |
| Medical Associates Health Contracted [320444] | $84 - $572 | 79% |
| First Health Contracted [320128] | $92 - $624 | 86% |
| United Medical Resources Contracted [320454] | $92 - $629 | 86% |
| Mercy Mgd Behavioral Health Contracted [320259] | $105 | 98% |
| Multiplan Contracted [320270] | $105 - $715 | 98% |
| Private Health Care Systems Contracted [320320] | $105 | 98% |
| Workers Comp [20426] | $105 - $762 | 98% |
| Healthlink Contracted [320179] | $113 - $848 | 106% |
| Aither Health Contracted [320449] | $119 - $810 | 111% |
| Aither Health [20449] | $119 - $810 | 111% |
| Auxiant Contracted [320462] | $119 - $810 | 111% |
| Ebms Contracted [320493] | $119 - $810 | 111% |
| Edison Health Solutions Contracted [320502] | $119 - $810 | 111% |
| Federal Medical Center Contracted [320127] | $119 - $810 | 111% |
| Imagine 360 Contracted [320494] | $119 - $810 | 111% |
| Insurance System Inc Contracted [320465] | $119 - $810 | 111% |
| Mercy Benefit Admin Contracted [320251] | $119 - $810 | 111% |
| Mercy Benefit Admin [20251] | $119 - $810 | 111% |
| Point C Contracted [320238] | $119 - $810 | 111% |
| Preferred Health Plan Contracted [320522] | $119 - $810 | 111% |
| Reflect Health Contracted [320492] | $119 - $810 | 111% |
| Show-Me Health Administrators Contracted [320483] | $119 - $810 | 111% |
| Tri State Healthcare Coalition Contracted [320379] | $119 - $810 | 111% |
| Yuzu Health Contracted [320521] | $119 - $810 | 111% |