CMS Price Transparency Data

Ultrasound, pelvis

Facility: Newport Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $438
Cash Discount Price: $515
vs. Medicare Baseline: 4.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Newport Community Hospital is $438. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $515. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.10x the Medicare baseline. Located in 714 West Pine Street, Newport, WA.

Cash / Self-Pay

$515

Average discount available for prompt cash payment at this facility.

Insurance Median

$438

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: $515 (482%)

Insurance Median: $438 (410%)

Cash: $515 (482% of Medicare)

Ins. Median: $438 (410% 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 410% of the Medicare baseline (a markup of 310%). 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
Pacificsource	$252	236%
Bcidaho	$255 - $438	239%
Molina	$255 - $386	239%
Wellcare	$255	239%
UnitedHealthcare	$265 - $489	248%
Wellpoint	$272	255%
Aetna	$402	376%
Premera	$438	410%
Cigna	$464	434%
Multiplan	$474	444%
Asuris	$489	458%
Regence_Wa	$489	458%
Firstchoice	$494	463%

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 $515.
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 Newport Community 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.