CMS Price Transparency Data

Ultrasound, pelvis

Facility: Excela Health Westmoreland Regional Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $100
Cash Discount Price: $296
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Excela Health Westmoreland Regional Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $296. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.94x the Medicare baseline. Located in 532 West Pittsburgh Street, Greensburg, PA.

Cash / Self-Pay

$296

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $296 (277%)

Insurance Median: $100 (94%)

Cash: $296 (277% of Medicare)

Ins. Median: $100 (94% 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
Highmark Advantage Community Blue	$40 - $99	37%
Senior Life	$43 - $107	40%
Health Partners Plan	$44 - $110	41%
Humana	$44 - $111	41%
Peak Health	$44 - $251	41%
United	$44 - $111	41%
Amerihealth Caritas	$45 - $112	42%
Cigna	$45 - $236	42%
Devoted	$45 - $112	42%
Geisinger	$45 - $112	42%
The Health Plan Of West Virginia	$45 - $251	42%
Highmark Wholecare	$46 - $116	43%
Pa Health And Wellness	$46 - $114	43%
Upmc	$46 - $115	43%
American Health Plan Of Pa	$47 - $117	44%
Provider Network Of America	$47 - $394	44%
Provider Plan Partners Plan	$47 - $117	44%
Upmc Health Plan	$50 - $263	47%
Highmark Children'S Health Insurance Program	$51 - $128	48%
Ambetter / Centene	$53 - $134	50%
Highmark	$58 - $236	54%
Upmc For Kids Chip	$60	56%
Velocity	$64 - $160	60%
Community Blue	$85 - $112	80%
Health Partners Plans	$92	86%
UnitedHealthcare	$109 - $272	102%
Aetna	$110 - $246	103%
Martin'S Point	$110	103%

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 $296.
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 Excela Health Westmoreland Regional 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.