CMS Price Transparency Data

Ultrasound, pelvis

Facility: Methodist Hospital Atascosa

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $323
Cash Discount Price: $3,060
vs. Medicare Baseline: 3.02x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Methodist Hospital Atascosa is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,060. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.02x the Medicare baseline. Located in 1905 Hwy 97 East, Jourdanton, TX.

Cash / Self-Pay

$3,060

Average discount available for prompt cash payment at this facility.

Insurance Median

$323

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: $3,060 (2865%)

Insurance Median: $323 (302%)

Cash: $3,060 (2865% of Medicare)

Ins. Median: $323 (302% 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 302% of the Medicare baseline (a markup of 202%). 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
Community First Health Plans	$96 - $826	90%
Molina	$96	90%
United	$96 - $1,377	90%
Aetna	$104 - $1,530	97%
Humana	$120	112%
Superior Health	$153	143%
Blue Cross Blue Shield	$196 - $903	184%
Imperial Insurance	$581	544%
Focus Health Solutions	$918	859%
Healthcare Highways	$943	883%
Valenz	$1,071	1003%
Evry Health	$1,126	1054%
Curative Administrators	$1,224	1146%
Healthsmart Preferred Care	$1,683	1576%
Multiplan	$2,295 - $2,601	2149%
Triwest Health Alliance	$2,295	2149%

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 $3,060.
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 Methodist Hospital Atascosa 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.