CMS Price Transparency Data

Ultrasound, pelvis

Facility: Southern Hills Hospital and Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $189
Cash Discount Price: $2,472
vs. Medicare Baseline: 1.77x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Southern Hills Hospital and Medical Center is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,472. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.77x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.

Cash / Self-Pay

$2,472

Average discount available for prompt cash payment at this facility.

Insurance Median

$189

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: $2,472 (2314%)

Insurance Median: $189 (177%)

Cash: $2,472 (2314% of Medicare)

Ins. Median: $189 (177% 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
Blue Cross Blue Shield	$33 - $138	31%
Ambetter / Centene	$37 - $519	35%
United	$79 - $539	74%
Aetna	$158	148%
Sierra	$189	177%
Corvel	$251	235%
Olympus Medsave Usa	$264 - $1,854	247%
Select Health	$534 - $570	500%
Cigna	$556	521%
Prominence Healthfirst	$742	695%
Cmn Global	$1,038	972%
Evernorth	$1,236	1157%
Nv Health & Welfare Trust	$1,483	1388%
Multiplan	$1,557 - $1,805	1458%
First Health	$1,632 - $1,978	1528%
Medcare International	$1,854	1736%

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 $2,472.
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 Southern Hills Hospital and 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.