CMS Price Transparency Data

Ultrasound, pelvis

Facility: Tristar Southern Hills Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $452
Cash Discount Price: $2,344
vs. Medicare Baseline: 4.23x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Tristar Southern Hills Medical Center is $452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,344. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.23x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.

Cash / Self-Pay

$2,344

Average discount available for prompt cash payment at this facility.

Insurance Median

$452

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: $2,344 (2195%)

Insurance Median: $452 (423%)

Cash: $2,344 (2195% of Medicare)

Ins. Median: $452 (423% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 423% of the Medicare baseline (a markup of 323%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$69 - $115	65%
Humana	$129 - $595	121%
Aetna	$148 - $1,189	139%
United	$155 - $1,070	145%
Cigna	$231 - $775	216%
Kentucky Labor Cabinet	$425 - $438	398%
Apex Health	$439 - $452	411%
Nhc Advantage, Inc.	$439 - $452	411%
Pruitt Health (Allyalign)	$439 - $452	411%
Centurion	$951 - $980	890%
Bgfh Singlesource	$1,154 - $2,021	1080%
Multiplan	$1,339 - $1,379	1254%
Employers Health Network	$1,616 - $1,665	1513%
Odom'S Tn Pride Sausage	$1,732 - $1,784	1622%
Beech Street	$2,032 - $2,093	1902%
Prime Health	$2,032 - $2,093	1902%

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 $2,344.
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 Tristar Southern Hills 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.