CMS Price Transparency Data

Ultrasound, pelvis

Facility: Beloit Health System

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $912
Cash Discount Price: $495
vs. Medicare Baseline: 8.54x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Beloit Health System is $912. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $495. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.54x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$495

Average discount available for prompt cash payment at this facility.

Insurance Median

$912

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: $495 (463%)

Insurance Median: $912 (854%)

Cash: $495 (463% of Medicare)

Ins. Median: $912 (854% 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 854% of the Medicare baseline (a markup of 754%). 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
Aetna	$72 - $1,768	67%
Blue Cross Blue Shield	$72 - $1,023	67%
Dean Health	$72 - $1,041	67%
Independent Care Health Plan	$72 - $110	67%
Quartz	$72 - $1,209	67%
UnitedHealthcare	$72 - $597	67%
Naphcare	$108 - $1,116	101%
Cook Children'S Health Plan (Cchp)	$110 - $930	103%
Humana	$110 - $1,395	103%
Managed Health Services	$110	103%
Molina Healthcare	$110	103%
Wellcare	$110	103%
The Alliance	$275 - $440	257%
Wps	$362 - $1,378	339%
Wea Trust	$865 - $1,023	810%
Multiplan	$1,259 - $1,488	1179%
Health Eos	$1,400 - $1,693	1311%
Cigna	$1,448 - $1,768	1356%
Hfn	$1,448 - $1,768	1356%
Preferred Network Access	$1,448 - $1,768	1356%

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 $495.
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 Beloit Health System 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.