CMS Price Transparency Data

Ultrasound, pelvis

Facility: Intermountain Health Heber Valley Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $605
  • Cash Discount Price: $522
  • vs. Medicare Baseline: 5.66x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Intermountain Health Heber Valley Hospital is $605. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $522. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.66x the Medicare baseline. Located in 454 East Medical Way, Heber City, UT.
Cash / Self-Pay
$522

Average discount available for prompt cash payment at this facility.

Insurance Median
$605

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: $522 (489%)
Insurance Median: $605 (566%)
Cash: $522 (489% of Medicare)
Ins. Median: $605 (566% 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 566% of the Medicare baseline (a markup of 466%). 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
Triwest $32 - $526 30%
Aetna $209 - $614 196%
American Health $209 196%
Blue Cross Blue Shield $209 - $615 196%
Health Partners Of Nevada $209 196%
Health Plan Of Nevada $209 - $619 196%
Healthy U $209 - $619 196%
Humana $209 196%
Molina $209 - $619 196%
Selecthealth $209 - $619 196%
UnitedHealthcare $209 - $615 196%
Awh Connected $339 - $622 317%
Byu Athletics $339 - $605 317%
Campbell Scientific $339 - $605 317%
Cigna $339 - $615 317%
Deseret Mutual $339 - $615 317%
Emi $339 - $615 317%
Emi Health $339 - $605 317%
Franklin County $339 - $605 317%
Ifit $339 - $605 317%
Intermountain Caregiver Plan $339 - $615 317%
Juniper Systems $339 - $605 317%
Lw Miller $339 - $605 317%
Managed Care Admin $339 - $605 317%
Motivhealth $339 - $605 317%
Pehp $339 - $626 317%
Prodegi Corp Benefit $339 - $605 317%
Tanner Llc $339 - $605 317%
Utah Tech $339 - $605 317%
Wise Network $339 - $605 317%
Corporation Of The President $522 489%
Corvel Corporation $522 489%
Injury Care Of Nevada $522 489%
Wcf Insurance $522 489%
Byu Risk Management $591 553%
Medcare International $591 553%
Springtide $591 553%
Uofu $591 553%
Global Excel $626 586%
Health Utah $626 586%
Hygeia Corporation $626 586%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 East Medical Way, Heber City, UT 84032
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals