CMS Price Transparency Data

Ultrasound, pelvis

Facility: Rehoboth McKinley Christian Health Care Services

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $708
Cash Discount Price: $294
vs. Medicare Baseline: 6.63x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Rehoboth McKinley Christian Health Care Services is $708. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.63x the Medicare baseline. Located in 1901 Red Rock Drive, Gallup, NM.

Cash / Self-Pay

$294

Average discount available for prompt cash payment at this facility.

Insurance Median

$708

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: $294 (275%)

Insurance Median: $708 (663%)

Cash: $294 (275% of Medicare)

Ins. Median: $708 (663% 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 663% of the Medicare baseline (a markup of 563%). 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
Medicare (plans)	$189 - $282	177%
Triwest	$189 - $282	177%
Usa	$208 - $310	195%
Coventry	$340 - $507	318%
UnitedHealthcare	$590 - $880	552%
Health West	$630 - $938	590%
Three Rivers	$630 - $938	590%
Blue Cross Blue Shield	$669 - $997	626%
Integrated Health	$669 - $997	626%
Humana	$708 - $1,056	663%
Multiplan	$708 - $1,056	663%
Cigna	$732 - $1,091	685%
Presbyterian	$732 - $1,091	685%
Associated Plan Administrators	$748 - $1,114	700%

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 $294.
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 Rehoboth McKinley Christian Health Care Services 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.