CMS Price Transparency Data

Ultrasound, pelvis

Facility: Alta Vista Regional Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $633
  • Cash Discount Price: $396
  • vs. Medicare Baseline: 5.93x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Alta Vista Regional Hospital is $633. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.93x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.
Cash / Self-Pay
$396

Average discount available for prompt cash payment at this facility.

Insurance Median
$633

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: $396 (371%)
Insurance Median: $633 (593%)
Cash: $396 (371% of Medicare)
Ins. Median: $633 (593% 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 593% of the Medicare baseline (a markup of 493%). 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
Commercial Hmo Ppo $95 - $792 89%
Medicaid / KanCare $102 - $792 95%
Php Centennial $102 95%
Medicare (plans) $111 - $792 104%
UnitedHealthcare $111 - $127 104%
Champus $127 - $792 119%
Mcare Mcaid Hmo Dual $127 119%
Workers Comp $211 - $792 198%
Self Pay $396 371%
Other Covernment $495 - $792 463%
Blue Cross Blue Shield $594 - $792 556%
Mva $792 742%
Other Government $792 742%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 104 Legion Drive, Las Vegas, NM 87701
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals