CMS Price Transparency Data

Ultrasound, pelvis

Facility: Grant Regional Health Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $866
  • Cash Discount Price: $773
  • vs. Medicare Baseline: 8.11x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Grant Regional Health Center is $866. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $773. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.11x the Medicare baseline. Located in 507 S Monroe St, Lancaster, WI.
Cash / Self-Pay
$773

Average discount available for prompt cash payment at this facility.

Insurance Median
$866

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: $773 (724%)
Insurance Median: $866 (811%)
Cash: $773 (724% of Medicare)
Ins. Median: $866 (811% 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 811% of the Medicare baseline (a markup of 711%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Americhoice Mcaid - All Plans $299 280%
Quartz Mcr Adv $523 490%
UnitedHealthcare $523 - $1,058 490%
Quartz Health Solution - All Other Plans $587 550%
Medical Associates - All Plans $866 811%
The Alliance - All Plans $900 843%
Wps - All Plans $965 903%
Blue Cross Blue Shield $1,011 947%
Dean Health Plan - All Plans $4,029 3772%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 507 S Monroe St, Lancaster, WI 53813
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals