CMS Price Transparency Data

Ultrasound, pelvis

Facility: Novant Health Presbyterian Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $507
Cash Discount Price: $579
vs. Medicare Baseline: 4.75x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Novant Health Presbyterian Medical Center is $507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $579. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.75x the Medicare baseline. Located in 200 Hawthorne Lane Box 33549, Charlotte, NC.

Cash / Self-Pay

$579

Average discount available for prompt cash payment at this facility.

Insurance Median

$507

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: $579 (542%)

Insurance Median: $507 (475%)

Cash: $579 (542% of Medicare)

Ins. Median: $507 (475% 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 475% of the Medicare baseline (a markup of 375%). 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
Blue Cross Blue Shield	$102 - $763	95%
Humana	$102 - $932	95%
Pace Of The Southern Piedmont	$102	95%
UnitedHealthcare	$102 - $756	95%
Aetna	$104 - $1,035	97%
Cigna	$105 - $666	98%
Liberty Health	$107	100%
Carolina Complete	$178 - $225	167%
Nc Department Of Public Safety	$178 - $225	167%
Amerihealth	$182 - $230	170%
Wellcare	$182 - $230	170%
Caresource North Carolina	$338 - $427	316%
Atlantic Corporation Dba Atlantic Packaging	$471 - $595	441%
Amps	$563 - $712	527%
Plotkin Health	$614 - $776	575%
Medcost	$726 - $970	680%
Primary Physician Care	$757 - $958	709%
Multiplan	$767 - $970	718%
Phcs	$767 - $970	718%
Employers Choice Network	$992 - $1,255	929%
Three Rivers Provider Network	$992 - $1,255	929%

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 $579.
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 Novant Health Presbyterian Medical Center 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.