CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cheshire Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $194
Cash Discount Price: $233
vs. Medicare Baseline: 1.82x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cheshire Medical Center is $194. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.82x the Medicare baseline. Located in 580 Court Street, Keene, NH.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$194

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: $233 (218%)

Insurance Median: $194 (182%)

Cash: $233 (218% of Medicare)

Ins. Median: $194 (182% 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.

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	$32 - $909	30%
Ambetter / Centene	$34 - $99	32%
Blue Cross Blue Shield	$34 - $1,056	32%
Cigna	$34 - $658	32%
Martin'S Point Generations Advantage	$34 - $111	32%
Martin'S Point Health Care	$34 - $111	32%
Mvp	$34 - $658	32%
UnitedHealthcare	$34 - $1,009	32%
Wellcare Health Plans	$34 - $111	32%
Wellsense Health Plan	$34 - $183	32%
Amerihealth Caritas Nh	$44 - $163	41%
Granite State Health Plan	$60 - $222	56%
Harvard Pilgrim Health Care Of Ne	$76 - $604	71%
Mass General Brigham Health Plan	$87 - $1,329	81%
Tufts Health Plan	$97 - $848	91%
Maine Community Health Options	$161 - $598	151%
First Health/Hcvm	$304 - $1,130	285%
Phcs	$322 - $1,196	301%

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 $233.
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 Cheshire 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.