CMS Price Transparency Data

Ultrasound, pelvis

Facility: The University of Vermont Health Network - Champl

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $97
Cash Discount Price: $652
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at The University of Vermont Health Network - Champl is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $652. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 75 Beekman Street, Plattsburgh, NY.

Cash / Self-Pay

$652

Average discount available for prompt cash payment at this facility.

Insurance Median

$97

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: $652 (610%)

Insurance Median: $97 (91%)

Cash: $652 (610% of Medicare)

Ins. Median: $97 (91% 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	$19 - $692	18%
UnitedHealthcare	$21 - $825	20%
Mvp	$26 - $860	24%
Aetna	$31 - $771	29%
Capital District Physicians' Health Plan	$31 - $852	29%
Fidelis Care	$31 - $130	29%
Humana	$31 - $123	29%
Martins Point	$31 - $139	29%
Veterans Affairs Community Care Network	$31 - $130	29%
Highmark Blueshield	$39 - $854	37%
Wellpath	$43 - $195	40%
St. Regis	$130 - $178	122%
Harvard Pilgrim	$178 - $865	167%
Magnacare	$178 - $865	167%
Coventry	$200 - $973	187%
Multiplan	$211 - $1,027	198%
Emblem Health	$865	810%

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 $652.
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 The University of Vermont Health Network - Champl 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.