CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medical City Lewisville

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $296
  • Cash Discount Price: $3,054
  • vs. Medicare Baseline: 2.77x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Medical City Lewisville is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,054. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.77x the Medicare baseline. Located in 500 West Main Street, Lewisville, TX.
Cash / Self-Pay
$3,054

Average discount available for prompt cash payment at this facility.

Insurance Median
$296

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: $3,054 (2859%)
Insurance Median: $296 (277%)
Cash: $3,054 (2859% of Medicare)
Ins. Median: $296 (277% 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 277% of the Medicare baseline (a markup of 177%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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%
Amerigroup $96 90%
Cook Childrens Health Plan $96 90%
Parkland Community Health Plan $96 90%
United $96 - $608 90%
Cigna $101 - $428 95%
Aetna $104 - $2,220 97%
Molina $106 - $108 99%
Humana $120 - $946 112%
Blue Cross Blue Shield $147 - $1,356 138%
Superior Health Plan $214 200%
Unicare $733 - $3,054 686%
Healthcare Highways $748 - $1,032 700%
Evry Health $788 738%
Curative Administrators $1,222 1144%
City Of Mckinney $1,374 1286%
Fidelis Securecare $1,374 1286%
National Choicecare $1,527 1430%
Pc Texas Partners $1,680 1573%
Physicians Coop Of Tx $1,680 1573%
Rockport Health Group $1,680 1573%
Averde Health, Inc $1,771 1658%
Usc Health Services $1,833 1716%
Coastal Comp Health Networks $2,138 2002%
Jostens $2,138 2002%
Mega Life $2,138 2002%
Multiplan Phcs $2,138 2002%
Healthsmart Preferred Care $2,291 2145%
Lewisville Isd/Dls Consulting $2,291 2145%
Usa Managed Care $2,443 2287%
Galaxy Health Network $2,596 2430%
Independent Medical Systems $3,054 2859%
National Healthcare Solutions $3,054 2859%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 West Main Street, Lewisville, TX 75057
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals