CMS Price Transparency Data

Ultrasound, pelvis

Facility: Columbia Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $101
Cash Discount Price: $178
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Columbia Memorial Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $178 (167%)

Insurance Median: $101 (95%)

Cash: $178 (167% of Medicare)

Ins. Median: $101 (95% 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
UnitedHealthcare	$13 - $178	12%
Mvp	$23 - $1,615	22%
Cdphp	$25 - $1,730	23%
Medicare (plans)	$25 - $111	23%
Blue Cross Blue Shield	$28 - $1,423	26%
Tricare	$28 - $111	26%
Medicaid / KanCare	$29 - $769	27%
Hamaspik	$31 - $1,046	29%
Emblem Health Ghi	$32 - $106	30%
Fidelis	$32 - $1,730	30%
Aetna	$35 - $302	33%
Blue Shield Highmark	$37 - $123	35%
Cigna	$44 - $149	41%
Emblem	$152 - $253	142%
Empire Plan Nyship	$176 - $201	165%
Magnacare	$182 - $203	170%
Blue Shield	$183	171%
Herrington Diversified Pdh	$189	177%
Multiplan	$213 - $903	199%
Mvp Commercial	$237 - $286	222%

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 $178.
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 Columbia Memorial 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.