CMS Price Transparency Data

Ultrasound, pelvis

Facility: Elizabethtown Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $125
Cash Discount Price: $660
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Elizabethtown Community Hospital is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $660. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.17x the Medicare baseline. Located in 75 Park Street, Elizabethtown, NY.

Cash / Self-Pay

$660

Average discount available for prompt cash payment at this facility.

Insurance Median

$125

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: $660 (618%)

Insurance Median: $125 (117%)

Cash: $660 (618% of Medicare)

Ins. Median: $125 (117% 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
Capital District Physicians' Health Plan	$66 - $1,007	62%
UnitedHealthcare	$68 - $1,128	64%
Harvard Pilgrim	$76 - $980	71%
Magnacare	$76 - $980	71%
Coventry	$81 - $1,041	76%
Fidelis Care	$83 - $466	78%
Mvp	$83 - $957	78%
Blue Cross Blue Shield	$85 - $921	80%
Multiplan	$86 - $1,102	81%
Humana	$92 - $101	86%
Aetna	$97 - $919	91%
Martins Point	$97 - $466	91%
Veterans Affairs Community Care Network	$97 - $466	91%
Choicecare	$107 - $980	100%
Highmark Blueshield	$120 - $998	112%
Wellpath	$136 - $698	127%
Emblem Health	$980	918%

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 $660.
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 Elizabethtown Community 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.