CMS Price Transparency Data

Ultrasound, pelvis

Facility: Carolinas Rehabilitation

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $308
Cash Discount Price: $644
vs. Medicare Baseline: 2.88x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Carolinas Rehabilitation is $308. 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 2.88x the Medicare baseline. Located in 1100 Blythe Blvd, Charlotte, NC.

Cash / Self-Pay

$644

Average discount available for prompt cash payment at this facility.

Insurance Median

$308

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: $308 (288%)

Cash: $644 (603% of Medicare)

Ins. Median: $308 (288% 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 288% of the Medicare baseline (a markup of 188%). 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
Amerihealth Caritas	$29 - $501	27%
Carolina Complete Health	$29 - $510	27%
Healthy Blue	$29 - $510	27%
UnitedHealthcare	$29 - $845	27%
Wellcare	$29 - $510	27%
Cigna	$30 - $869	28%
Humana	$31 - $108	29%
Aetna	$32 - $1,094	30%
Ambetter / Centene	$58 - $479	54%
Blue Cross Blue Shield	$63 - $619	59%
Choicecare	$66 - $1,004	62%
Medcost	$88 - $863	82%
Employers Health Network	$569	533%
Physician Reach Out	$644	603%
Quik Trip	$837	784%
Healthgram	$1,030	964%
Private Health Care Systems	$1,056	989%
First Health	$1,094	1024%
Beechstreet	$1,185	1109%
Multiplan	$1,185	1109%

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 $644.
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 Carolinas Rehabilitation 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.