CMS Price Transparency Data

Ultrasound, pelvis

Facility: Methodist Richardson Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $137
Cash Discount Price: $630
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Methodist Richardson Medical Center is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $630. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.28x the Medicare baseline. Located in 2831 E President George Bush Highway, Richardson, TX.

Cash / Self-Pay

$630

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $630 (590%)

Insurance Median: $137 (128%)

Cash: $630 (590% of Medicare)

Ins. Median: $137 (128% 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	$91 - $112	85%
Aetna	$105 - $170	98%
Blue Cross Blue Shield	$105 - $428	98%
Covid19 Hrsa Uninsured Testing And Treatment Fund [6005]	$105	98%
Medicare (plans)	$105 - $112	98%
Ust Health Proof [1005]	$105	98%
Wellcare [7016]	$105	98%
American Health Advantage Of Texas [7099]	$110	103%
Cigna	$110 - $194	103%
Globalhealth [1003]	$110	103%
Procare Advantage [7018]	$110	103%
Humana	$111	104%
Southwestern Health Resources Swhr [7015]	$111	104%
Provider Partners Health Plan [7025]	$113	106%
Coralvita [9216]	$126	118%
Alternative Service Concepts [8005]	$131	123%
Oscar Insurance Company [2057]	$137	128%
Bright Healthcare [2222]	$147	138%
Molina [3017]	$152	142%
Wellpoint Marketplace Exchange [3071]	$163	153%
90 Degree Benefit [3057]	$173	162%
Allied National [2031]	$173	162%
Entrust/90 Degree [2058]	$173	162%
Friday Health Plan [2061]	$179	168%
Ambetter / Centene	$180	169%
Imperial Insurance Companies [3073]	$189	177%
Web Tpa [3049]	$194	182%
Evry Health [1013]	$210	197%
Sana Benefits [3069]	$210	197%
Velocity [3070]	$210	197%
Health Plans Inc [5017]	$263	246%
Medical Cost Containment Professionals [3059]	$263	246%
Dart Member Care [3039]	$284	266%
Healthscope Benefits [2052]	$284	266%
Healthscope Benefits [3063]	$284	266%
Medicaid / KanCare	$394	369%

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 $630.
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 Richardson 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.