CMS Price Transparency Data

Ultrasound, pelvis

Facility: Frye Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $179
Cash Discount Price: $722
vs. Medicare Baseline: 1.68x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Frye Regional Medical Center is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $722. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.68x the Medicare baseline. Located in 420 N Center St, Hickory, NC.

Cash / Self-Pay

$722

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $722 (676%)

Insurance Median: $179 (168%)

Cash: $722 (676% of Medicare)

Ins. Median: $179 (168% 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.

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
Ambetter / Centene	$95	89%
Veteran Family Member Program	$99	93%
Humana	$100	94%
UnitedHealthcare	$100 - $182	94%
Aetna	$102 - $132	95%
Blue Cross Blue Shield	$179 - $271	168%
Amerihealth Caritas North Carolina	$182	170%
Carolina Complete Health Inc.	$182	170%
Partners Health Management	$182	170%
Wellcare Of North Carolina, Inc	$184	172%
Cigna	$253	237%
Sherrill Furniture	$309	289%
Amerihealth Caritas Next	$420	393%

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 $722.
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 Frye Regional 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.