CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lewisgale Hospital Pulaski

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $2,266
Cash Discount Price: $3,777
vs. Medicare Baseline: 21.22x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lewisgale Hospital Pulaski is $2,266. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,777. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.22x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.

Cash / Self-Pay

$3,777

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,266

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: $3,777 (3536%)

Insurance Median: $2,266 (2122%)

Cash: $3,777 (3536% of Medicare)

Ins. Median: $2,266 (2122% 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 2122% of the Medicare baseline (a markup of 2022%). 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	$113 - $421	106%
United	$245 - $1,700	229%
Lifeworks	$718	672%
Universal Healthcare Group	$831	778%
Virginia Health Network	$1,322 - $2,682	1238%
Aetna	$1,700	1592%
Greenvbrier Sporting Club	$2,266	2122%
Corvel	$2,719	2546%
Richfield Nursing Center	$2,833	2652%
Richfield Retirement Community	$2,833	2652%
Multiplan	$2,908	2723%
Community Care Network	$3,022	2829%
Graham-White Manufacturing	$3,022	2829%
Occunet Workers Comp	$3,022	2829%
One Health Plan	$3,022	2829%
Patients Choice	$3,324	3112%
4Most	$3,399	3182%
American Postal Workers Union	$3,399	3182%
Phcs	$3,399	3182%
Star Transportation	$3,399	3182%

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 $3,777.
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 Pulaski 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.