CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medina Regional Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $327
  • Cash Discount Price: $746
  • vs. Medicare Baseline: 3.06x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Medina Regional Hospital is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $746. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.06x the Medicare baseline. Located in 3100 Avenue E, Hondo, TX.
Cash / Self-Pay
$746

Average discount available for prompt cash payment at this facility.

Insurance Median
$327

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: $746 (698%)
Insurance Median: $327 (306%)
Cash: $746 (698% of Medicare)
Ins. Median: $327 (306% 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 306% of the Medicare baseline (a markup of 206%). 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
Aetna $137 - $498 128%
Amerigroup $137 128%
Superior Health Plan $137 - $321 128%
Community First Health Plan $144 - $829 135%
Curative $183 - $498 171%
UnitedHealthcare $199 - $622 186%
Amerivantage $274 257%
Cigna $332 311%
Blue Advantage $415 389%
Blue Cross Blue Shield $481 450%
Benefit Administrators $829 776%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Avenue E, Hondo, TX 78861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals