CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mc Camey Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $561
Cash Discount Price: $638
vs. Medicare Baseline: 5.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mc Camey Hospital is $561. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $638. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.25x the Medicare baseline. Located in 2500 Hwy 305 South, McCamey, TX.

Cash / Self-Pay

$638

Average discount available for prompt cash payment at this facility.

Insurance Median

$561

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: $638 (597%)

Insurance Median: $561 (525%)

Cash: $638 (597% of Medicare)

Ins. Median: $561 (525% 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 525% of the Medicare baseline (a markup of 425%). 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
Superior Healthplan	$96 - $255	90%
Wellpoint	$137 - $850	128%
Capstar	$160 - $425	150%
Firstcare Star	$315 - $391	295%
UnitedHealthcare	$420 - $561	393%
Blue Cross Blue Shield	$518 - $765	485%
Aetna	$561 - $722	525%
Humana	$561 - $680	525%
Multiplan	$561	525%
Cigna	$680	637%
Three Rivers Provider	$722	676%
Galaxy	$765	716%
Healthsmart	$765	716%
Swhp Mco	$765	716%

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 $638.
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 Mc Camey Hospital 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.