CMS Price Transparency Data

Ultrasound, pelvis

Facility: Sanford Chamberlain Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $916
  • Cash Discount Price: $986
  • vs. Medicare Baseline: 8.58x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Sanford Chamberlain Medical Center is $916. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $986. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.58x the Medicare baseline. Located in 300 S Byron, Chamberlain, SD.
Cash / Self-Pay
$986

Average discount available for prompt cash payment at this facility.

Insurance Median
$916

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: $986 (923%)
Insurance Median: $916 (858%)
Cash: $986 (923% of Medicare)
Ins. Median: $916 (858% 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 858% of the Medicare baseline (a markup of 758%). 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
Sanford Health Plan Align $422 395%
Ucare $453 - $1,083 424%
Wellmark Sd $453 - $1,073 424%
Aetna $457 - $1,071 428%
Health Partners $457 - $925 428%
Medicare (plans) $457 428%
UnitedHealthcare $457 - $1,030 428%
Primewest $466 436%
Sanford Health Plan $676 - $906 633%
Security Health Plan $678 635%
Medica $1,017 - $1,088 952%
First Choice Health Network $1,110 1039%
Healthez $1,110 1039%
Multiplan $1,110 1039%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 S Byron, Chamberlain, SD 57325
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals