CMS Price Transparency Data

Ultrasound, pelvis

Facility: High Point Regional Health System

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $530
Cash Discount Price: $625
vs. Medicare Baseline: 4.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at High Point Regional Health System is $530. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $625. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.96x the Medicare baseline. Located in 601 N Elm St, High Point, NC.

Cash / Self-Pay

$625

Average discount available for prompt cash payment at this facility.

Insurance Median

$530

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: $625 (585%)

Insurance Median: $530 (496%)

Cash: $625 (585% of Medicare)

Ins. Median: $530 (496% 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 496% of the Medicare baseline (a markup of 396%). 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
Amerihealth	$181 - $406	169%
Carolina Complete	$181	169%
Healthy Blue	$181	169%
Partners	$181	169%
UnitedHealthcare	$183 - $835	171%
Vaya	$183	171%
Wellcare	$183	171%
Alliance	$185	173%
Trillium	$187	175%
Medcost	$335 - $801	314%
Aetna	$372 - $812	348%
Oscar	$375 - $500	351%
Ambetter / Centene	$400	374%
Blue Cross Blue Shield	$535 - $858	501%
Cigna	$686	642%
Directnet	$739	692%
Private Healthcare Systems	$1,025	960%
Multiplan	$1,125	1053%
Humana	$1,162 - $1,188	1088%

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 $625.
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 High Point Regional Health System 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.