CMS Price Transparency Data

Ultrasound, pelvis

Facility: University Health System, Inc

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $103
Cash Discount Price: $140
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at University Health System, Inc is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.96x the Medicare baseline. Located in 1924 Alcoa Highway, Knoxville, TN.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $140 (131%)

Insurance Median: $103 (96%)

Cash: $140 (131% of Medicare)

Ins. Median: $103 (96% 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
Aetna	$31 - $391	29%
Blue Cross Blue Shield	$31 - $358	29%
Bluecare	$31 - $33	29%
Choicecare	$31 - $43	29%
Cigna	$31 - $424	29%
Humana	$31 - $97	29%
Nhc	$31 - $103	29%
UnitedHealthcare	$31 - $391	29%
American Health	$32 - $103	30%
Devoted Health	$32 - $101	30%
Tenncare	$33	31%
Coventry	$44 - $391	41%
First Health	$49	46%
Multiplan	$49 - $335	46%
Initial Group	$50	47%
Beechstreet	$59 - $419	55%
Novanet	$59	55%
Wellpoint	$99 - $103	93%
Wellcare-Windsor Medadv	$102	95%
Medicare (plans)	$103 - $104	96%
Fentress County Sheriffs Dept	$224	210%
Nx Health	$335	314%
Phcs	$335	314%
Naphcare	$363	340%
Prime Health	$419 - $559	392%
Seven Corners	$419	392%
Usa	$447	419%
Evolutions	$503	471%
Galaxy	$503	471%
Healthsmart	$503	471%

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 $140.
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 University Health System, Inc 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.