CMS Price Transparency Data

Ultrasound, pelvis

Facility: Howard County Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $327
Cash Discount Price: $909
vs. Medicare Baseline: 3.06x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Howard County Medical Center is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $909. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.06x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$909

Average discount available for prompt cash payment at this facility.

Insurance Median

$327

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: $909 (851%)

Insurance Median: $327 (306%)

Cash: $909 (851% of Medicare)

Ins. Median: $327 (306% 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 306% of the Medicare baseline (a markup of 206%). 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
Medica Standard Premier	$30 - $96	28%
Aetna	$31 - $864	29%
Medica Elevate	$59 - $188	55%
Midland'S Choice	$62 - $198	58%
Humana	$80	75%
Blue Cross Blue Shield	$94 - $864	88%
Great Plains	$94 - $518	88%
Medica Chi	$94 - $518	88%
Tricare	$94 - $682	88%
UnitedHealthcare	$94 - $873	88%
Nebraska Total Care - Wellcare	$97	91%
Molina Healthcare	$99 - $454	93%
Oscar Health	$164	154%
Ambetter / Centene	$188	176%
Beshp	$188	176%
Nebraska Total Care	$454	425%
Medica Chi Aco	$827	774%
Medica Choice National	$827	774%
Medica Ifb Aco	$873	817%
Medica Ifb Open Access	$873	817%

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 $909.
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 Howard County 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.