CMS Price Transparency Data

Ultrasound, pelvis

Facility: Metro Nashville General Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $33
Cash Discount Price: $559
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Metro Nashville General Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $559. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.31x the Medicare baseline. Located in 1818 Albion Street, Nashville, TN.

Cash / Self-Pay

$559

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $559 (523%)

Insurance Median: $33 (31%)

Cash: $559 (523% of Medicare)

Ins. Median: $33 (31% 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	$18 - $33	17%
Corizon	$22	21%
Amerigroup	$29	27%
Amerivantage	$29	27%
Cigna	$29 - $33	27%
Aetna	$33 - $513	31%
Blue	$33	31%
Humana	$33	31%
Medicare (plans)	$33	31%
Upmc	$33	31%
Wellcare	$33	31%
Farm Bureau	$34	32%
Bluecare	$36	34%
Corecivic	$36	34%
Tenncare	$36	34%
Ambetter / Centene	$46	43%
Naphcare	$49	46%
Provider Network Of America	$56	52%
Blue Cross Blue Shield	$102 - $135	95%

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 $559.
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 Metro Nashville General Hospital 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.