CMS Price Transparency Data

Ultrasound, pelvis

Facility: Springfield Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,611
Cash Discount Price: $1,513
vs. Medicare Baseline: 15.08x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Springfield Hospital is $1,611. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,513. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.08x the Medicare baseline. Located in Po Box 2003, Springfield, VT.

Cash / Self-Pay

$1,513

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,611

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: $1,513 (1417%)

Insurance Median: $1,611 (1508%)

Cash: $1,513 (1417% of Medicare)

Ins. Median: $1,611 (1508% 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 1508% of the Medicare baseline (a markup of 1408%). 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	$766 - $2,017	717%
Mvp Health Plan	$766 - $1,553	717%
UnitedHealthcare	$766 - $1,815	717%
Wellsense	$766 - $2,017	717%
Harvard Pilgrim Health Care	$774 - $1,669	725%
Wellcare	$789	739%
Tufts Health Plan	$1,239	1160%
Cigna	$1,416 - $2,098	1326%
Multiplan	$1,674	1567%
Aetna	$1,916	1794%
Coventry	$1,916	1794%
Beacon Health	$2,017	1888%
Manage Behavioral Health	$2,017	1888%
Martin'S Point Healthcare	$2,017	1888%

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 $1,513.
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 Springfield Hospital 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.