CMS Price Transparency Data

Ultrasound, pelvis

Facility: Harper County Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $343
Cash Discount Price: $275
vs. Medicare Baseline: 3.21x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Harper County Community Hospital is $343. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $275. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.21x the Medicare baseline. Located in 1003 Us Highway 64 North, Buffalo, OK.

Cash / Self-Pay

$275

Average discount available for prompt cash payment at this facility.

Insurance Median

$343

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: $275 (257%)

Insurance Median: $343 (321%)

Cash: $275 (257% of Medicare)

Ins. Median: $343 (321% 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 321% of the Medicare baseline (a markup of 221%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Cigna	$245	229%
UnitedHealthcare	$268 - $292	251%
Va Ccn Op/Profee Only-All Plans	$268	251%
Healthchoice Op/Profee Only-All Plans	$275	257%
Provider Network Of America Op/Profee Only-All Pla	$309	289%
Blue Cross Blue Shield	$333 - $547	312%
Aetna	$343	321%
Humana	$343	321%
Ok Complete Health Mcaid Op/Profee Only	$343	321%
Ok Complete Health Comm Op/Profee Only-All Other P	$348	326%
Medicare (plans)	$361	338%

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 $275.
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 Harper County 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.