CMS Price Transparency Data

Ultrasound, pelvis

Facility: Boone County Health Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $775
  • Cash Discount Price: $803
  • vs. Medicare Baseline: 7.26x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Boone County Health Center is $775. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $803. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.26x the Medicare baseline. Located in P O Box 151, 723 West Fairview St, Albion, NE.
Cash / Self-Pay
$803

Average discount available for prompt cash payment at this facility.

Insurance Median
$775

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: $803 (752%)
Insurance Median: $775 (726%)
Cash: $803 (752% of Medicare)
Ins. Median: $775 (726% 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 726% of the Medicare baseline (a markup of 626%). 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
Blue Cross Blue Shield $466 - $763 436%
Good Samaritan Insurance Plan Of Nebraska $466 436%
Medica $771 722%
Aetna $779 729%
Ambetter / Centene $779 729%
Midlands Choice $787 737%
Bryan Health Connect $931 872%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: P O Box 151, 723 West Fairview St, Albion, NE 68620
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals