CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lincoln Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $652
Cash Discount Price: $735
vs. Medicare Baseline: 6.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lincoln Hospital is $652. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $735. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.10x the Medicare baseline. Located in 10 Nichols Street, Davenport, WA.

Cash / Self-Pay

$735

Average discount available for prompt cash payment at this facility.

Insurance Median

$652

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: $735 (688%)

Insurance Median: $652 (610%)

Cash: $735 (688% of Medicare)

Ins. Median: $652 (610% 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 610% of the Medicare baseline (a markup of 510%). 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
Labor & Industries - All Plans	$58	54%
Ambetter / Centene	$382	358%
Molina Hlthy Options	$382	358%
UnitedHealthcare	$382 - $719	358%
Amerigroup Mcaid - All Plans	$405	379%
Aetna	$458 - $776	429%
Indian Hlth Services - All Plans	$458	429%
Tricare	$458	429%
Va Ccn - All Plans	$458	429%
Cigna	$623	583%
Molina Exchange-All Other Plans	$650	609%
Focus Healthcare Mgmt - All Plans	$654	612%
Blue Cross Blue Shield	$719	673%
Uniform Medical Plan-All Plans	$719	673%
First Health Coventry-All Plans	$727	681%
Health Management Network-All Plans	$735	688%
Three Rivers-All Plans	$735	688%
Asuris Nw Health-All Plans	$752	704%
Multiplan-All Plans	$776	727%
Physician Hosp Comm Org-All Plans	$776	727%
First Choice Health- All Plans	$792	742%

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 $735.
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 Lincoln 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.