CMS Price Transparency Data

Ultrasound, pelvis

Facility: Wheatland Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $242
  • Cash Discount Price: $471
  • vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Wheatland Memorial Hospital is $242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $471. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.27x the Medicare baseline. Located in 530 3Rd St Nw, Harlowton, MT.
Cash / Self-Pay
$471

Average discount available for prompt cash payment at this facility.

Insurance Median
$242

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: $471 (441%)
Insurance Median: $242 (227%)
Cash: $471 (441% of Medicare)
Ins. Median: $242 (227% 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 227% of the Medicare baseline (a markup of 127%). 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 $32 - $51 30%
Healthnet Federal-All Plans $32 - $410 30%
Humana $32 - $410 30%
Pacific Source Mcr Adv $32 - $410 30%
Triwest-All Plans $32 - $410 30%
UnitedHealthcare $32 - $659 30%
Medica Prime Solutions-All Plans $33 - $410 31%
Allegiance Provider-All Plans $52 - $571 49%
First Choice Big Sky-All Plans $52 - $638 49%
Naphcare-All Plans $52 49%
Community Health Ntwk-All Plans $57 - $638 53%
Interwest Ppo-All Plans $57 - $638 53%
Mountain Health Co-Op-All Plans $57 - $638 53%
Rocky Mountain Health Network-All Plans $57 - $638 53%
6 Degrees Health-All Plans $58 - $638 54%
Ccn-All Plans $58 - $652 54%
First Health-All Plans $58 - $645 54%
Pacific Steel & Recycling-All Plans $63 - $638 59%
City Of Billings-All Plans $68 - $1,008 64%
Pacific Source-All Other Plans $71 - $638 66%
Amish Old Orders-All Plans $202 - $504 189%
Fedmed Network-All Plans $229 - $638 214%
Americas Choice-All Plans $256 - $638 240%
Three Rivers-All Plans $256 - $638 240%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 3Rd St Nw, Harlowton, MT 59036
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals