CMS Price Transparency Data

Ultrasound, pelvis

Facility: St Marys Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $98
  • Cash Discount Price: $1,163
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at St Marys Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,163. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.92x the Medicare baseline. Located in 2900 1St Avenue, Huntington, WV.
Cash / Self-Pay
$1,163

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $1,163 (1089%)
Insurance Median: $98 (92%)
Cash: $1,163 (1089% of Medicare)
Ins. Median: $98 (92% 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.

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
The Healthplan $25 - $69 23%
Unicare $25 - $69 23%
Aetna $31 - $1,047 29%
Blue Cross Blue Shield $31 - $743 29%
Humana $31 - $106 29%
Peak Health $31 - $989 29%
Peia $31 - $118 29%
UnitedHealthcare $31 - $1,101 29%
Caresource $34 - $1,105 32%
Medicare (plans) $106 99%
Cigna $1,059 991%
Firsthealth $1,105 1035%
Healthsmart $1,105 1035%
Phcs Multiplan $1,105 1035%
Zelis Network $1,105 1035%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2900 1St Avenue, Huntington, WV 25702
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals