CMS Price Transparency Data

Ultrasound, pelvis

Facility: Caromont Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $267
  • Cash Discount Price: $1,276
  • vs. Medicare Baseline: 2.50x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Caromont Regional Medical Center is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,276. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.50x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.
Cash / Self-Pay
$1,276

Average discount available for prompt cash payment at this facility.

Insurance Median
$267

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: $1,276 (1195%)
Insurance Median: $267 (250%)
Cash: $1,276 (1195% of Medicare)
Ins. Median: $267 (250% 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 250% of the Medicare baseline (a markup of 150%). 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 $107 - $372 100%
UnitedHealthcare $107 - $196 100%
Aetna $111 - $413 104%
Devoted Health $112 105%
Healthteam $112 105%
Longevity Health $112 105%
Molina $112 - $358 105%
Humana $114 - $1,123 107%
Surgery Plus $187 175%
Carolina Complete Health $192 180%
Partners Behavioral Health $192 180%
Alliance Behavioral Health $196 184%
Amerihealth Caritas $196 184%
Carolina Complete Health Tailored Plans $196 184%
Vaya Behavioral Health $196 184%
Wellcare $196 184%
Cigna $199 - $347 186%
Carolina Caring $267 - $1,011 250%
Corporate Benefits Service $287 269%
Absolute Total Care $358 335%
Gaston County Jail $384 360%
Medcost $868 813%
Self Pay $957 896%
Beech Street $1,046 979%
Multiplan $1,046 979%
First Health Network $1,212 1135%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2525 Court Dr, Gastonia, NC 28052
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals