CMS Price Transparency Data
Ultrasound, pelvis
Facility: Mercy Hospital Oklahoma City, Inc
Billing Code: 76856 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76856
- Insurance Median: $297
- Cash Discount Price: $991
- vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Oklahoma City, Inc is $297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $991. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.78x the Medicare baseline. Located in 4300 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$991
Average discount available for prompt cash payment at this facility.
Insurance Median
$297
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: $991 (928%)
Insurance Median: $297 (278%)
Cash: $991 (928% of Medicare)
Ins. Median: $297 (278% 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 278% of the Medicare baseline (a markup of 178%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $40 - $137 | 37% |
| Aetna | $61 - $1,102 | 57% |
| Humana | $61 - $1,052 | 57% |
| Tricare | $94 - $99 | 88% |
| Blue Cross Blue Shield | $99 - $106 | 93% |
| Champva [20065] | $99 | 93% |
| Cherokee Nation Health Serv Contracted [320066] | $99 | 93% |
| Cross Timbers Hospice [20098] | $99 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $99 | 93% |
| Elara Caring Aspire Hospice Contracted [320433] | $99 | 93% |
| Elara Caring Aspire Hospice [20433] | $99 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $99 | 93% |
| Halo Hcr Inc Hospice [20432] | $99 | 93% |
| Indian Health Service Contracted [320198] | $99 | 93% |
| Kindful Hospice Contracted [320434] | $99 | 93% |
| Kindful Hospice [20434] | $99 | 93% |
| Longevity Health Plan [10477] | $99 | 93% |
| Medicare (plans) | $99 - $106 | 93% |
| Mercy Hospice Okc [20252] | $99 | 93% |
| Provider Partners Health Plans Contracted [320450] | $99 | 93% |
| Qual Choice Contracted [320325] | $99 | 93% |
| UnitedHealthcare | $99 - $222 | 93% |
| Globalhealth Contracted [320145] | $101 | 95% |
| Cigna | $102 - $133 | 95% |
| Amg Spec Hosp Edmond [20034] | $106 | 99% |
| Globalhealth Contracted [320144] | $130 | 122% |
| Ambetter / Centene | $137 | 128% |
| Home State Health Plan Contracted [320187] | $137 | 128% |
| Novasys Contracted [320285] | $137 | 128% |
| Community Care Contracted [320080] | $152 - $1,067 | 142% |
| Workers Comp [20426] | $183 | 171% |
| Health Choice Contracted [320166] | $213 | 199% |
| United Medical Resources Contracted [320454] | $222 - $991 | 208% |
| Healthsmart Preferred Care Contracted [320184] | $223 - $991 | 209% |
| Kempton Contracted [320214] | $223 | 209% |
| Medica Contracted [320239] | $483 | 452% |
| Healthcare Highways Plus Contracted [320175] | $594 - $914 | 556% |
| Webtpa Contracted [320417] | $640 | 599% |
| Osma Health Contracted [320292] | $686 | 642% |
| Aither Health Contracted [320449] | $914 | 856% |
| Auxiant Contracted [320462] | $914 - $991 | 856% |
| Benefit Management Contracted [320052] | $914 - $991 | 856% |
| Ebms Contracted [320493] | $914 | 856% |
| Healthlink Contracted [320179] | $914 - $991 | 856% |
| Imagine 360 Contracted [320494] | $914 | 856% |
| Mercy Benefit Admin Contracted [320251] | $914 - $991 | 856% |
| Quik Trip Contracted [320447] | $914 | 856% |
| Reflect Health Contracted [320492] | $914 | 856% |
| Show-Me Health Administrators Contracted [320483] | $914 | 856% |
| Yuzu Health Contracted [320521] | $914 | 856% |
| First Health Contracted [320128] | $939 | 879% |
| Federal Medical Center Contracted [320127] | $991 | 928% |
| Healthscope Contracted [320182] | $991 | 928% |
| Healthsmart Accel Contracted [320183] | $991 | 928% |
| Point C Contracted [320238] | $991 | 928% |
| Preferred Health Plan Contracted [320522] | $991 | 928% |
| Private Health Care Systems Contracted [320320] | $991 - $1,067 | 928% |
| Tri State Healthcare Coalition Contracted [320379] | $991 | 928% |
| Multiplan Contracted [320270] | $1,067 - $1,372 | 999% |
| Preferred Community Choice Contracted [320311] | $1,158 | 1084% |
| Centralink Contracted [320480] | $1,524 | 1427% |
| Mercy Rehab Hospital Contracted [320260] | $1,600 | 1498% |