CMS Price Transparency Data

Ultrasound, pelvis

Facility: Pioneer Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $773
  • Cash Discount Price: $651
  • vs. Medicare Baseline: 7.24x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Pioneer Medical Center is $773. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $651. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.24x the Medicare baseline. Located in 301 W 7Th Ave, Big Timber, MT.
Cash / Self-Pay
$651

Average discount available for prompt cash payment at this facility.

Insurance Median
$773

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: $651 (609%)
Insurance Median: $773 (724%)
Cash: $651 (609% of Medicare)
Ins. Median: $773 (724% 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 724% of the Medicare baseline (a markup of 624%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $366 - $676 343%
Health Info Net Mcr Adv $366 343%
Healtnet Federal-All Plans $366 343%
Humana $366 - $749 343%
Triwest Va Pccc-All Plans $366 343%
UnitedHealthcare $366 - $773 343%
Rocky Mountain Health Network-All Plans $570 534%
Allegiance Provider-All Plans $692 648%
Mountain Health Co-Op Hpn $716 670%
6 Degrees Health-All Plans $773 724%
Americas Choice-All Plans $773 724%
City Of Billings-All Plans $773 724%
Community Health Ntwk-All Plans $773 724%
Ebms Select Care Network-All Plans $773 724%
Fedmed Network-All Plans $773 724%
First Choice Big Sky-All Plans $773 724%
First Health-All Plans $773 724%
Interwest Ppo $773 724%
Mountain Health Co-Op-All Other Plans $773 724%
Pacific Source-All Plans $773 724%
Pacific Steel & Recycling-All Plans $773 724%
Three Rivers-All Plans $773 724%
Health Info Net Peak/Equity $790 740%
Health Info Net Standard-All Other Plans $790 740%
Mountain Health Co-Op Ppo/Pos $798 747%
Interwest Health Traditional-All Other Plans $814 762%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 W 7Th Ave, Big Timber, MT 59011
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals