CMS Price Transparency Data

Ultrasound, pelvis

Facility: Novant Health Thomasville Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $240
Cash Discount Price: $776
vs. Medicare Baseline: 2.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Novant Health Thomasville Medical Center is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $776. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 207 Old Lexington Rd Box 789, Thomasville, NC.

Cash / Self-Pay

$776

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

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: $776 (727%)

Insurance Median: $240 (225%)

Cash: $776 (727% of Medicare)

Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). 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	$101 - $889	95%
Humana	$101 - $1,008	95%
Pace Of The Southern Piedmont	$101	95%
UnitedHealthcare	$101 - $871	95%
Aetna	$104 - $1,035	97%
Cigna	$104 - $788	97%
Liberty Health	$106	99%
Nc Department Of Public Safety	$203 - $235	190%
Carolina Complete	$235	220%
Amerihealth	$240	225%
Wellcare	$240	225%
Caresource North Carolina	$518	485%
Atlantic Corporation Dba Atlantic Packaging	$731	684%
Plotkin Health	$776	727%
Amps	$841	787%
Medcost	$1,100 - $1,216	1030%
Primary Physician Care	$1,139	1066%
Multiplan	$1,165	1091%
Phcs	$1,165	1091%
Employers Choice Network	$1,255	1175%
Three Rivers Provider Network	$1,255	1175%

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 $776.
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 Thomasville 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.