CMS Price Transparency Data

Ultrasound, pelvis

Facility: Round Rock Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $650
  • Cash Discount Price: $1,818
  • vs. Medicare Baseline: 6.09x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Round Rock Medical Center is $650. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,818. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.09x the Medicare baseline. Located in 2400 Round Rock Ave, Round Rock, TX.
Cash / Self-Pay
$1,818

Average discount available for prompt cash payment at this facility.

Insurance Median
$650

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: $1,818 (1702%)
Insurance Median: $650 (609%)
Cash: $1,818 (1702% of Medicare)
Ins. Median: $650 (609% 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 609% of the Medicare baseline (a markup of 509%). 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.

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
Superior Health Plan $70 - $382 66%
Amerigroup $73 68%
St David’S Hospice $96 90%
United $98 - $1,010 92%
Blue Cross Blue Shield $101 - $716 95%
Molina Healthcare $106 99%
Humana $120 112%
Sendero $120 112%
Aetna $121 - $705 113%
Moda $327 - $528 306%
Covenant Management Systems $401 - $647 375%
Healthcare Highways $405 - $674 379%
Imo Med - Select Network $417 - $674 390%
Nomi Health $445 - $831 417%
Moda Health $501 - $831 469%
Evry Health $512 - $826 479%
Texas Healthcare Foundation Heb $515 - $831 482%
Texas Workforce Commission $542 - $876 507%
Curative Administrators $556 - $898 521%
Harbor Health Team $556 - $898 521%
Averde Health $626 - $1,010 586%
Comanche County $696 - $1,122 652%
National Choicecare $696 - $1,122 652%
Healthsmart Preferred Care $765 - $1,796 716%
Independent Medical Systems $765 - $1,235 716%
Physicians Cooperative Of Texas $765 - $1,235 716%
Prime Health $835 - $1,347 782%
First Health $876 - $1,614 820%
Coastal Comp Health Networks $904 - $1,459 846%
National Health Care $904 - $1,459 846%
Occunet $974 - $1,572 912%
Texas Municipal League $974 - $1,572 912%
Medcorp Southwest $1,043 - $1,684 977%
Preferred Health Arrangement $1,043 - $1,684 977%
Rockport Healthcare Group $1,113 - $2,020 1042%
Bce Emergis Corporation $1,252 - $2,020 1172%
Beech Street $1,252 - $2,020 1172%
Medical Control Network Solutions $1,252 - $2,020 1172%
Multiplan $1,252 - $2,020 1172%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Round Rock Ave, Round Rock, TX 78681
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals