CMS Price Transparency Data

Ultrasound, pelvis

Facility: Methodist Fremont Health

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $777
Cash Discount Price: $426
vs. Medicare Baseline: 7.27x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Methodist Fremont Health is $777. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $426. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.27x the Medicare baseline. Located in 450 East 23Rd St, Fremont, NE.

Cash / Self-Pay

$426

Average discount available for prompt cash payment at this facility.

Insurance Median

$777

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: $426 (399%)

Insurance Median: $777 (727%)

Cash: $426 (399% of Medicare)

Ins. Median: $777 (727% 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 727% of the Medicare baseline (a markup of 627%). 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
Aetna	$114 - $1,380	107%
Blue Cross Blue Shield	$114 - $1,221	107%
Humana	$114	107%
Medica	$114	107%
Medicare (plans)	$114 - $117	107%
UnitedHealthcare	$114 - $1,295	107%
Ambetter / Centene	$237	222%
Elite Choice	$237	222%
Elevate By Medica	$388 - $647	363%
Alliance Nhn	$502 - $836	470%
Ne Furniture Mart	$716 - $1,193	670%
Medica Choice	$759 - $1,265	711%
Multiplan	$777 - $1,293	727%
Midlands Choice	$811 - $1,351	759%

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 $426.
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 Methodist Fremont Health 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.