CMS Price Transparency Data

Ultrasound, pelvis

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $120
Cash Discount Price: $245
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Ochsner Stennis Memorial Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$120

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: $245 (229%)

Insurance Median: $120 (112%)

Cash: $245 (229% of Medicare)

Ins. Median: $120 (112% 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.

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
Prime Health Services Ppo -Workers Comp	$59 - $186	55%
Cor Vel	$60 - $190	56%
Humana	$61 - $336	57%
UnitedHealthcare	$77 - $286	72%
Medicaid / KanCare	$81 - $90	76%
Cigna	$86 - $336	81%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$90 - $339	84%
Medicare (plans)	$90 - $386	84%
Ambetter / Centene	$92 - $339	86%
Select Administrative Services Network	$94 - $392	88%
Shared Health Mississippi	$94 - $353	88%
Aetna	$98 - $364	92%
Primewell Health Services Commercial Exchange Plan	$101 - $375	95%
Primewell Health Services – Commercial	$101 - $375	95%
Prime Health Services Ppo	$103 - $448	96%
Claritev D/B/A Multiplan/Phcs/American Life Care	$113 - $420	106%
Zelis	$113 - $420	106%
Blue Cross Blue Shield	$156 - $351	146%

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 $245.
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 Ochsner Stennis Memorial Hospital 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.