CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lee County Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $183
  • Cash Discount Price: $100
  • vs. Medicare Baseline: 1.71x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lee County Community Hospital is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.71x the Medicare baseline. Located in 127 Health Care Drive, Pennington Gap, VA.
Cash / Self-Pay
$100

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $100 (94%)
Insurance Median: $183 (171%)
Cash: $100 (94% of Medicare)
Ins. Median: $183 (171% 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.

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
UnitedHealthcare $87 - $434 81%
Blue Cross Blue Shield $89 - $434 83%
Aetna $95 - $434 89%
Ambetter / Centene $95 89%
Amerigroup $95 - $434 89%
Managed Medicaire $95 89%
Medicare (plans) $95 89%
Mountain Empire Pace $95 89%
Sentara Health $95 - $112 89%
United Mine Workers Of America $95 89%
Humana $97 91%
Molina Healthcare $99 - $312 93%
Cigna $100 - $434 94%
Devoted Health Plan $100 94%
Nhc Advantage $100 94%
Seven Corners, Inc. $229 214%
Optima Health $300 281%
First Health Coventry $434 406%
Medcost $434 406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 127 Health Care Drive, Pennington Gap, VA 24277
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals