CMS Price Transparency Data

Ultrasound, pelvis

Facility: Leconte Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $109
Cash Discount Price: $113
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Leconte Medical Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.02x the Medicare baseline. Located in 742 Middlecreek Road, Sevierville, TN.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $113 (106%)

Insurance Median: $109 (102%)

Cash: $113 (106% of Medicare)

Ins. Median: $109 (102% 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
UnitedHealthcare	$53 - $230	50%
Blue Cross Blue Shield	$85 - $331	80%
Farm Bureau	$103	96%
Aetna	$104 - $109	97%
Tricare	$104	97%
Wellpoint	$106 - $109	99%
Humana	$107	100%
Cigna	$109 - $160	102%
Devoted Health	$109	102%
Wellcare	$109	102%
Ehn	$164	154%
Ambetter / Centene	$176	165%
Correctional Medical Services	$218	204%
Community Services Network	$237	222%
Usa Managed Care Organization	$255	239%
Novanet	$273	256%
Direct Care America	$291	272%
Medsave Usa	$291	272%
National Provider Network	$291	272%
Beech Street	$309	289%
Ccn Managed Care	$309	289%
Initial Group	$320	300%
Galaxy Health Network	$328	307%

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 $113.
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 Leconte Medical Center 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.