CMS Price Transparency Data

Ultrasound, pelvis

Facility: Merit Health Women's Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $94
  • Cash Discount Price: $249
  • vs. Medicare Baseline: 0.88x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Merit Health Women's Hospital is $94. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $249. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.88x the Medicare baseline. Located in 1026 River Oaks Drive, Flowood, MS.
Cash / Self-Pay
$249

Average discount available for prompt cash payment at this facility.

Insurance Median
$94

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: $249 (233%)
Insurance Median: $94 (88%)
Cash: $249 (233% of Medicare)
Ins. Median: $94 (88% 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

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
Cigna $14 - $502 13%
Self Pay $14 - $506 13%
UnitedHealthcare $18 - $656 17%
Trimed Billing Solutions $19 - $690 18%
State Hospital $24 - $874 22%
First Choice Mpcn $28 - $1,035 26%
First Choice Standard $29 - $1,058 27%
Coventry First Health $33 - $1,197 31%
First Choice Ppo Plus $35 - $1,266 33%
Aetna $44 - $1,611 41%
Benefit Management Systems $45 - $1,956 42%
First Choice Stratose $50 - $1,841 47%
Health Choice Of Mississippi $50 - $1,841 47%
Prime Health Services $50 - $1,841 47%
Mississippi Department Of Rehabilitation Services $63 - $2,301 59%
Ms Work Comp $63 - $140 59%
Veterans Eval Services $63 - $91 59%
Medicaid / KanCare $81 - $351 76%
Magnolia Mcd Ms Chip $82 77%
Caresource Truecare $83 78%
Molina Chip $88 82%
Tricare $90 84%
Humana $93 87%
Medicare (plans) $93 87%
Node Shared Health Of Ms Mcr Adv $93 87%
Node Vantage Health Mcr Adv $93 87%
Node Windsor Mcr Adv $93 87%
Node Champva $94 88%
Node Va $94 88%
Node Devoted Health Mcr Adv $95 89%
Node First Choice American Health Of Ms Mcr Adv $95 89%
Node Molina Mcr Adv $95 89%
Node First Choice Wellcare Mcr Adv $96 90%
Node Healthy Mississippi Mcr Adv $104 97%
Node Us Dept Of Labor $118 110%
First Choice Preferred $142 133%
Occunet $142 133%
Node First Choice Seven Corners $160 150%
Magnolia Exchange $165 154%
Molina Exchange $171 160%
First Choice Lgp $206 193%
Vantage Health $212 198%
Advanced Health Systems $242 227%
Blue Cross Blue Shield $312 292%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1026 River Oaks Drive, Flowood, MS 39232
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals