CMS Price Transparency Data

Ultrasound, pelvis

Facility: PAM Health Specialty Hospital of Reno

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,454
  • Cash Discount Price: $1,865
  • vs. Medicare Baseline: 13.61x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at PAM Health Specialty Hospital of Reno is $1,454. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,865. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.61x the Medicare baseline. Located in 235 W 6Th St, Reno, NV.
Cash / Self-Pay
$1,865

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,454

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: $1,865 (1746%)
Insurance Median: $1,454 (1361%)
Cash: $1,865 (1746% of Medicare)
Ins. Median: $1,454 (1361% 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 1361% of the Medicare baseline (a markup of 1261%). 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
America'S Choice $1,305 1222%
Provider Network Of Amercia $1,398 1309%
Quik Trip $1,398 1309%
Usa Managed Care Organization $1,398 1309%
Velocity Provider Ppo Network $1,398 1309%
Healthsmart $1,454 1361%
Evolutions Healthcare System $1,492 1397%
Multiplan $1,492 1397%
Beech Street $1,585 1484%
Galaxy Health Network $1,585 1484%
Prime Health Services $1,585 1484%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 235 W 6Th St, Reno, NV 89503
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL