CMS Price Transparency Data

Ultrasound, pelvis

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $141
Cash Discount Price: $192
vs. Medicare Baseline: 1.32x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Memorial Mission Hospital and Asheville Surgery Ce is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $192. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.32x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$192

Average discount available for prompt cash payment at this facility.

Insurance Median

$141

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: $192 (180%)

Insurance Median: $141 (132%)

Cash: $192 (180% of Medicare)

Ins. Median: $141 (132% 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
Blue Cross Blue Shield	$33 - $285	31%
United	$33 - $917	31%
Amerihealth	$34 - $296	32%
Partners Health Management	$34 - $299	32%
Vaya Health	$34 - $299	32%
Wellcare	$34 - $294	32%
Apex Health	$36 - $310	34%
Cigna	$66 - $773	62%
Caresource	$78 - $683	73%
Medcost	$100 - $1,319	94%
Magellan	$107 - $931	100%
Magellan Behavioral Health	$107 - $931	100%
Aetna	$129 - $1,122	121%
Multiplan	$142 - $1,241	133%
Avalon Administrative Services	$151 - $1,319	141%
Prime Health	$157 - $1,397	147%

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 $192.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.