Ultrasound, pelvis
Facility: Rio Grande Regional Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $1,674
- Cash Discount Price: $4,437
- vs. Medicare Baseline: 15.67x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 1567% of the Medicare baseline (a markup of 1467%). 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.
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% |
| United | $98 - $2,110 | 92% |
| Driscoll Children'S Health Plan | $99 | 93% |
| Aetna | $104 | 97% |
| Molina Healthcare | $106 | 99% |
| Healthcare Highways | $213 | 199% |
| Blue Cross Blue Shield | $253 - $2,110 | 237% |
| Superior Health Plan | $293 - $328 | 274% |
| Texas Athletic Network | $300 - $600 | 281% |
| Humana | $333 | 312% |
| Texas Workforce Commission | $1,004 - $1,125 | 940% |
| Cigna | $1,356 - $2,002 | 1270% |
| Averde Health | $1,381 - $1,547 | 1293% |
| Allegian Health | $1,674 - $1,876 | 1567% |
| Curative Administrators | $1,674 - $1,876 | 1567% |
| Healthsmart Preferred Care | $1,799 - $3,985 | 1684% |
| First Health | $2,406 - $2,696 | 2253% |
| National Healthcare Solutions | $2,511 - $2,813 | 2351% |
| Southwest Medical | $2,511 - $2,813 | 2351% |
| Coastal Comp | $2,720 - $3,048 | 2547% |
| Usa Managed Care | $2,720 - $3,751 | 2547% |
| Ppo Next/ Medical Control | $3,138 - $3,517 | 2938% |
| Beech Street | $3,348 - $3,751 | 3135% |
| Multiplan | $3,348 - $3,751 | 3135% |