CMS Price Transparency Data

Ultrasound, pelvis

Facility: North Carolina Baptist Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $347
  • Cash Discount Price: $524
  • vs. Medicare Baseline: 3.25x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at North Carolina Baptist Hospital is $347. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $524. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.25x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$524

Average discount available for prompt cash payment at this facility.

Insurance Median
$347

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: $524 (491%)
Insurance Median: $347 (325%)
Cash: $524 (491% of Medicare)
Ins. Median: $347 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Aetna $103 - $915 96%
Apex $103 96%
Blue Cross Blue Shield $103 - $412 96%
Cigna $103 - $646 96%
Devoted $103 96%
Healthteam $103 96%
UnitedHealthcare $103 - $372 96%
Wellcare $103 - $247 96%
Humana $104 - $589 97%
Medicare (plans) $104 97%
Liberty $118 110%
Medcost $202 - $716 189%
Amerihealth $231 - $290 216%
Carolina Complete $231 - $243 216%
Health Blue $231 - $243 216%
Partners $231 - $243 216%
Vaya $233 - $246 218%
Alliance $235 - $248 220%
Trillium $237 - $251 222%
Ambetter / Centene $275 - $291 257%
Oscar $306 - $388 286%
Directnet $603 - $637 565%
Cone Health $714 - $754 668%
Healthgram $714 - $754 668%
First Carolina Care $816 - $862 764%
Private Healthcare Systems $836 - $883 783%
Multiplan $918 - $969 859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals