CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lewisgale Hospital Alleghany

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,351
Cash Discount Price: $2,501
vs. Medicare Baseline: 12.65x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lewisgale Hospital Alleghany is $1,351. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,501. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.65x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.

Cash / Self-Pay

$2,501

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,351

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: $2,501 (2342%)

Insurance Median: $1,351 (1265%)

Cash: $2,501 (2342% of Medicare)

Ins. Median: $1,351 (1265% 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 1265% of the Medicare baseline (a markup of 1165%). 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	$167 - $623	156%
United	$245 - $1,125	229%
Lifeworks	$475	445%
Universal Healthcare Group	$550	515%
Virginia Health Network	$875 - $1,776	819%
Aetna	$1,351	1265%
Greenvbrier Sporting Club	$1,501	1405%
Corvel	$1,801	1686%
Csx Hotels	$2,001	1873%
Occunet Workers Comp	$2,001	1873%
Health Payors Organization	$2,126	1990%
American Postal Workers Union	$2,251	2107%
4Most	$2,251	2107%
Community Care Network	$2,251	2107%
C&O Employees Hospital Assn	$2,251	2107%
Multiplan	$2,251	2107%
Alleghany Highland Community	$2,251	2107%
One Health Plan	$2,251	2107%

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 $2,501.
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 Alleghany 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.