CMS Price Transparency Data

Ultrasound, pelvis

Facility: Stanly Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $220
  • Cash Discount Price: $644
  • vs. Medicare Baseline: 2.06x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Stanly Regional Medical Center is $220. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $644. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.06x the Medicare baseline. Located in 301 Yadkin St, Albemarle, NC.
Cash / Self-Pay
$644

Average discount available for prompt cash payment at this facility.

Insurance Median
$220

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: $644 (603%)
Insurance Median: $220 (206%)
Cash: $644 (603% of Medicare)
Ins. Median: $220 (206% 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 206% of the Medicare baseline (a markup of 106%). 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
Trillium $28 - $161 26%
Alliance $29 - $159 27%
Amerihealth Caritas $29 - $157 27%
Carolina Complete Health $29 - $156 27%
Healthy Blue $29 - $156 27%
Partners $29 - $155 27%
UnitedHealthcare $29 - $872 27%
Vaya $29 - $157 27%
Wellcare $29 - $156 27%
Cigna $30 - $1,030 28%
Humana $31 - $103 29%
Aetna $32 - $1,159 30%
Ambetter / Centene $58 - $479 54%
Choicecare $66 - $1,210 62%
Blue Cross Blue Shield $83 - $663 78%
Medcost $88 - $1,236 82%
Employers Health Network $569 - $744 533%
Physician Reach Out $644 603%
Magellan $773 724%
Gmmi $837 784%
Quik Trip $837 784%
Carolina Behavioral Health $927 - $1,030 868%
First Health $1,159 1085%
Healthgram $1,159 1085%
Lifesynch Community Choice Care $1,210 1133%
Multiplan $1,210 1133%
Private Health Care Systems $1,210 1133%
Beechstreet $1,236 1157%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 301 Yadkin St, Albemarle, NC 28001
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals