CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lewisgale Hospital Montgomery

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,637
Cash Discount Price: $2,728
vs. Medicare Baseline: 15.33x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lewisgale Hospital Montgomery is $1,637. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,728. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.33x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$2,728

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,637

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: $2,728 (2554%)

Insurance Median: $1,637 (1533%)

Cash: $2,728 (2554% of Medicare)

Ins. Median: $1,637 (1533% 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 1533% of the Medicare baseline (a markup of 1433%). 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
Blue Cross Blue Shield	$137 - $509	128%
United	$245 - $1,228	229%
Cigna	$475	445%
Lifeworks	$518	485%
Universal Healthcare Group	$600	562%
Virginia Health Network	$955 - $1,937	894%
Greenvbrier Sporting Club	$1,637	1533%
Corvel	$1,964	1839%
Richfield Nursing Center	$2,046	1916%
Richfield Retirement Community	$2,046	1916%
Multiplan	$2,101	1967%
Community Care Network	$2,182	2043%
Graham-White Manufacturing	$2,182	2043%
Occunet Workers Comp	$2,182	2043%
One Health Plan	$2,182	2043%
Phcs	$2,319	2171%
Patients Choice	$2,401	2248%
4Most	$2,455	2298%
American Postal Workers Union	$2,455	2298%
Star Transportation	$2,455	2298%

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 $2,728.
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 Lewisgale Hospital Montgomery 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.