CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hawkins County Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $191
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hawkins County Memorial Hospital is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.79x the Medicare baseline. Located in 851 Locust Street, Rogersville, TN.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$191

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: $102 (95%)
Insurance Median: $191 (179%)
Cash: $102 (95% of Medicare)
Ins. Median: $191 (179% 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 $48 - $677 45%
Blue Cross Blue Shield $50 - $292 47%
Aetna $95 - $289 89%
Humana $95 89%
Managed Medicaire $95 89%
Medicare (plans) $95 89%
Sentara Health $95 - $175 89%
United Mine Workers Of America $95 89%
Amerigroup $99 93%
Cigna $100 - $365 94%
Devoted Health Plan $100 94%
Molina Healthcare $100 - $239 94%
Mountain Empire Pace $100 94%
Nhc Advantage $100 94%
Wellcare $101 - $677 95%
Ambetter / Centene $207 194%
Optima Health $234 219%
Medcost $322 301%
First Health Coventry $609 570%
Seven Corners, Inc. $677 634%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 851 Locust Street, Rogersville, TN 37857
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals