CMS Price Transparency Data

Ultrasound, pelvis

Facility: Baylor Scott & White Medical Center -Taylor

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $430
Cash Discount Price: $482
vs. Medicare Baseline: 4.03x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Baylor Scott & White Medical Center -Taylor is $430. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.03x the Medicare baseline. Located in 305 Mallard, Taylor, TX.

Cash / Self-Pay

$482

Average discount available for prompt cash payment at this facility.

Insurance Median

$430

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: $482 (451%)

Insurance Median: $430 (403%)

Cash: $482 (451% of Medicare)

Ins. Median: $430 (403% 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 403% of the Medicare baseline (a markup of 303%). 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
Baylor Scott & White Health Plan	$160 - $344	150%
Triwest	$169	158%
American Health Plan	$177	166%
Blue Cross Blue Shield	$177 - $430	166%
Corvel	$177	166%
Healthspring	$177	166%
Prime Health Services	$177	166%
Procare Advantage	$177	166%
Superior Health Plan	$177	166%
Careworks Fka Rockport	$210	197%
Injury Management Organization	$210	197%
Sedgwick	$210	197%
Cigna	$413 - $484	387%
Aetna	$442	414%
Midcoast	$442	414%
Quiktrip	$442	414%
UnitedHealthcare	$444	416%
University Of Mary Hardin-Baylor	$466	436%
Independent Medical System	$482	451%
Curative	$522	489%
Humana	$522 - $562	489%
First Health	$562	526%
Healthsmart	$562 - $602	526%
Private Health Care System	$602	564%
Bluebell Creameries	$642	601%
Three Rivers	$642	601%

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 $482.
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 Baylor Scott & White Medical Center -Taylor 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.