CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Hospital Logan County

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $549
  • Cash Discount Price: $595
  • vs. Medicare Baseline: 5.14x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Logan County is $549. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $595. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.14x the Medicare baseline. Located in 200 S Academy Rd, Guthrie, OK.
Cash / Self-Pay
$595

Average discount available for prompt cash payment at this facility.

Insurance Median
$549

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: $595 (557%)
Insurance Median: $549 (514%)
Cash: $595 (557% of Medicare)
Ins. Median: $549 (514% 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 514% of the Medicare baseline (a markup of 414%). 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.

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
Aetna $61 - $537 57%
Humana $61 - $732 57%
Medicaid / KanCare $61 - $274 57%
Tricare $227 213%
Blue Cross Blue Shield $233 - $439 218%
Cherokee Nation Health Serv Contracted [320066] $233 218%
Cross Timbers Hospice [20098] $233 218%
Dept Of Veteran Affairs Contracted [320106] $233 218%
Elara Caring Aspire Hospice Contracted [320433] $233 218%
Elara Caring Aspire Hospice [20433] $233 218%
Halo Hcr Inc Hospice Contracted [320432] $233 218%
Halo Hcr Inc Hospice [20432] $233 218%
Independent Health [20197] $233 218%
Indian Health Service Contracted [320198] $233 218%
Kindful Hospice Contracted [320434] $233 218%
Kindful Hospice [20434] $233 218%
Medical Associates Health [20444] $233 218%
Medicare (plans) $233 - $458 218%
Mercy Hospice Okc [20252] $233 218%
Provider Partners Health Plans Contracted [320450] $233 218%
Qual Choice Contracted [320325] $233 218%
Tribute Health Plan Mcr Contracted [320338] $233 218%
UnitedHealthcare $233 - $640 218%
Globalhealth Contracted [320145] $238 223%
Health Choice Contracted [320166] $239 224%
Cigna $241 - $778 226%
Ambetter / Centene $274 257%
Home State Health Plan Contracted [320187] $274 257%
Novasys Contracted [320285] $274 257%
Webtpa Contracted [320417] $384 360%
Medica Contracted [320239] $458 429%
Community Care Contracted [320080] $472 442%
Aither Health Contracted [320449] $549 - $778 514%
Auxiant Contracted [320462] $549 - $778 514%
Federal Medical Center Contracted [320127] $549 514%
Healthlink Contracted [320179] $549 - $778 514%
Healthscope Contracted [320182] $549 514%
Mercy Benefit Admin Contracted [320251] $549 - $778 514%
Point C Contracted [320238] $549 514%
Preferred Health Plan Contracted [320522] $549 514%
Quik Trip Contracted [320447] $549 514%
Show-Me Health Administrators Contracted [320483] $549 514%
United Medical Resources Contracted [320454] $549 - $640 514%
Osma Health Contracted [320292] $640 599%
United Behavioral Health Contracted [320390] $640 599%
Benefit Management Contracted [320052] $686 - $824 642%
Globalhealth Contracted [320144] $686 642%
Healthcare Highways Plus Contracted [320175] $686 642%
Private Health Care Systems Contracted [320320] $686 - $732 642%
First Health Contracted [320128] $716 670%
Multiplan Contracted [320270] $732 - $824 685%
Ebms Contracted [320493] $778 728%
Imagine 360 Contracted [320494] $778 728%
Preferred Community Choice Contracted [320311] $778 728%
Reflect Health Contracted [320492] $778 728%
Yuzu Health Contracted [320521] $778 728%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 S Academy Rd, Guthrie, OK 73044
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals