CMS Price Transparency Data

Ultrasound, pelvis

Facility: Sanford Canton-Inwood Medical Center - Cah

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $723
  • Cash Discount Price: $779
  • vs. Medicare Baseline: 6.77x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Sanford Canton-Inwood Medical Center - Cah is $723. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $779. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.77x the Medicare baseline. Located in 440 North Hiawatha Drive, Canton, SD.
Cash / Self-Pay
$779

Average discount available for prompt cash payment at this facility.

Insurance Median
$723

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: $779 (729%)
Insurance Median: $723 (677%)
Cash: $779 (729% of Medicare)
Ins. Median: $723 (677% 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 677% of the Medicare baseline (a markup of 577%). 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 $333 312%
Ucare $357 - $856 334%
Wellmark $357 - $847 334%
Aetna $361 - $846 338%
Health Partners $361 - $730 338%
Medicare (plans) $361 338%
UnitedHealthcare $361 - $813 338%
Primewest $368 345%
Sanford Health Plan $534 - $716 500%
Security Health Plan $536 502%
Medica $804 - $859 753%
First Choice Health Network $877 821%
Healthez $877 821%
Multiplan $877 821%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 440 North Hiawatha Drive, Canton, SD 57013
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals