CMS Price Transparency Data

Ultrasound, pelvis

Facility: Indiana Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $119
  • Cash Discount Price: $341
  • vs. Medicare Baseline: 1.11x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Indiana Regional Medical Center is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $341. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.11x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.
Cash / Self-Pay
$341

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

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: $341 (319%)
Insurance Median: $119 (111%)
Cash: $341 (319% of Medicare)
Ins. Median: $119 (111% 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.

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
UnitedHealthcare $53 - $422 50%
Upmc Health Plan $56 - $485 52%
Amerihealth Caritas $61 - $113 57%
Geisinger Health Plan $61 - $113 57%
Ambetter / Centene $63 - $113 59%
Highmark Wholecare $74 - $109 69%
Highmark $80 - $300 75%
Tricare $96 - $1,054 90%
Humana $97 - $107 91%
Aetna $98 - $334 92%
Cigna $98 - $279 92%
Medicare (plans) $98 - $109 92%
United Mine Workers Of America $98 - $109 92%
Geisinger $138 - $305 129%
Pa Health And Wellness Commercial $138 - $305 129%
Department Of Human Services And Torrance State Hospital $438 - $664 410%
Premier Comp Solutions, Llc $626 - $949 586%
Miscellaneous Commercial $696 - $1,054 652%
Pa Workers Compensation $696 - $1,054 652%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 Hospital Road, Indiana, PA 15701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals