CMS Price Transparency Data

Ultrasound, pelvis

Facility: Erlanger Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $100
Cash Discount Price: $113
vs. Medicare Baseline: 0.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Erlanger Medical Center is $100. 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 0.94x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$113

Average discount available for prompt cash payment at this facility.

Insurance Median

$100

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: $100 (94%)

Cash: $113 (106% of Medicare)

Ins. Median: $100 (94% 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	$27 - $252	25%
Amerigroup	$30 - $299	28%
Caresource	$31 - $299	29%
Peach State Hlth Plan	$31 - $83	29%
Bluecare	$34 - $315	32%
Cigna	$34 - $644	32%
Aetna	$38 - $701	36%
Devoted Health	$38 - $149	36%
Humana	$42 - $174	39%
Atrio Health	$46 - $157	43%
Point Comfort Underwriters	$46 - $258	43%
Alexian	$49 - $143	46%
Pruitthealth Premier	$53 - $147	50%
Blue Cross Blue Shield	$82 - $1,145	77%
Occunet	$93 - $251	87%
Clover	$98 - $143	92%
Upmc	$98 - $143	92%
American Health	$100 - $147	94%
Wellpoint	$100	94%
Nhc	$102 - $150	95%
Ambetter / Centene	$122 - $179	114%
Medicare (plans)	$143	134%
Simpra Advantage	$157	147%
Pnoa	$198 - $244	185%
Caresource Ga	$203 - $363	190%
Caresource Tn	$203 - $363	190%
Olympus	$215 - $1,073	201%
Alliant	$229 - $1,073	214%
Caresource Nc	$245 - $363	229%
First Health	$1,145 - $1,216	1072%

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 Erlanger 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.