CMS Price Transparency Data

Ultrasound, pelvis

Facility: Artesia General Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $517
Cash Discount Price: $775
vs. Medicare Baseline: 4.84x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Artesia General Hospital is $517. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $775. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.84x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$775

Average discount available for prompt cash payment at this facility.

Insurance Median

$517

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: $775 (726%)

Insurance Median: $517 (484%)

Cash: $775 (726% of Medicare)

Ins. Median: $517 (484% 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 484% of the Medicare baseline (a markup of 384%). 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
Zelis	$88 - $517	82%
Triwest	$101	95%
Blue Cross Blue Shield	$103 - $775	96%
Geha	$103 - $1,034	96%
Humana	$103 - $113	96%
Molina Healthcare Of New Mexico	$103 - $173	96%
Presbyterian Health Plan	$103 - $136	96%
UnitedHealthcare	$103 - $1,098	96%
Vistacare Hospice	$103	96%
First Health	$132 - $1,163	124%
New Mexico Health Connections	$175	164%
Providence Risk & Insurance Services	$206 - $1,227	193%
Omni Networks	$904	846%
Three Rivers Provider Network	$969	907%
Cigna	$1,098 - $1,163	1028%
Galaxy Health	$1,163	1089%
One Health Plan	$1,163	1089%
Multiplan	$1,176	1101%
United Payors & United Providers	$1,202	1125%

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 $775.
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 Artesia General Hospital 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.