CMS Price Transparency Data

Ultrasound, pelvis

Facility: Nacogdoches Memorial Hospital

Billing Code: 76856 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$199

about 1.9× the $107 Medicare rate · typically $129–$321

modeled estimate · not a bill or quote

What this hospital charges insurers

$194

About the fair price

about $5 under the fair price · 1.8× Medicare

Medicare pays $107 Fair price $199 This hospital $194 Cash price $128 Hospital's list price $425

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $32 Priciest $194

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Ultrasound, pelvis is about $199 (about 1.9× the $107 Medicare rate). Nacogdoches Memorial Hospital charges insurers about $194, or about $128 in cash — about the fair price. Located in Nacogdoches, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$194	182%
Blue Cross Blue Shieldmajor	$116 - $340	109%
Aetnamajor	$168 - $340	157%
Humanamajor	$102	95%
Cigna HealthSpring	$107	100%
Health Net	$158 - $319	148%
Molina	$107 - $425	100%
WellMed	$102 - $425	95%
+ 1 smaller / regional plan	$149 - $425

Excludes 3 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 128), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 76856.

Insurance Before you use insurance

Call your insurance company to confirm Nacogdoches Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 76856.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Nacogdoches Memorial Hospital

Compare: Ultrasound, pelvis at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.