CMS Price Transparency Data

Ultrasound, pelvis

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $241
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Intermountain Health St Vincent Regional Hospital is $241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.26x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$241

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%)

Insurance Median: $241 (226%)

Ins. Median: $241 (226% 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 226% of the Medicare baseline (a markup of 126%). 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
Medicare (plans)	$106	99%
UnitedHealthcare	$108 - $296	101%
First Choice Health	$173 - $288	162%
Other	$173 - $288	162%
Ebms-Employee Benefit Mng	$179 - $277	168%
Exchange Other	$179 - $212	168%
Mt Health Co-Op	$179 - $212	168%
Meritain Health	$199 - $247	186%
Sibanye Stillwater Health Partners	$202	189%
Aetna	$205	192%
Coastal Administrative Services	$213	199%
Allegiance	$221 - $292	207%
Cigna	$221 - $290	207%
Blue Cross Blue Shield	$222 - $270	208%
Pacificsource	$247 - $292	231%
Pacific Steel And Recycling	$266	249%
Preferred One	$277 - $300	259%
Interwest	$290	272%
Private Hlthcare Sys	$293	274%
Geha	$296	277%

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 $X.
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 Intermountain Health St Vincent Regional 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.