CMS Price Transparency Data

Ultrasound, pelvis

Facility: Valley Regional Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $612
Cash Discount Price: $6,123
vs. Medicare Baseline: 5.73x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Valley Regional Medical Center is $612. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,123. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.73x the Medicare baseline. Located in 100 A Alton Gloor, Brownsville, TX.

Cash / Self-Pay

$6,123

Average discount available for prompt cash payment at this facility.

Insurance Median

$612

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: $6,123 (5733%)

Insurance Median: $612 (573%)

Cash: $6,123 (5733% of Medicare)

Ins. Median: $612 (573% 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 573% of the Medicare baseline (a markup of 473%). 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
Texas Health Network	$95	89%
Usa Mco	$96	90%
United	$98 - $2,755	92%
Driscoll Childrens Health Plan	$99	93%
Aetna	$104 - $797	97%
Molina Healthcare	$106	99%
Healthcare Highways	$213	199%
Blue Cross Blue Shield	$242 - $2,755	227%
Texas Athletic Network	$300 - $600	281%
Superior Health Plan	$429	402%
Humana	$756	708%
Texas Workforce Commission	$1,469	1375%
Cigna	$1,984 - $2,614	1858%
Averde Health	$2,021	1892%
Curative Administrators	$2,449	2293%
Healthsmart Preferred Care	$2,633 - $5,204	2465%
First Health	$3,521	3297%
National Healthcare Solutions	$3,674	3440%
Southwest Medical	$3,674	3440%
Coastal Comp	$3,980	3726%
Total E&P Mexico	$3,980	3726%
Affiliated Healthcare	$4,164	3899%
Mcm Maxcare	$4,898	4586%
Pronet Ppo	$4,898	4586%
Usa Managed Care	$4,898	4586%
Beech Street	$5,511	5160%

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 $6,123.
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 Valley Regional 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.