CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cody Regional Health

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $591
Cash Discount Price: $605
vs. Medicare Baseline: 5.53x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cody Regional Health is $591. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $605. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.53x the Medicare baseline. Located in 707 Sheridan Avenue, Cody, WY.

Cash / Self-Pay

$605

Average discount available for prompt cash payment at this facility.

Insurance Median

$591

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: $605 (566%)

Insurance Median: $591 (553%)

Cash: $605 (566% of Medicare)

Ins. Median: $591 (553% 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 553% of the Medicare baseline (a markup of 453%). 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
Medica Comm - All Other Plans	$31 - $720	29%
Tricare	$32 - $368	30%
Mountain Health - All Plans	$51 - $720	48%
Blue Cross Blue Shield	$129 - $761	121%
Pacific Source - All Plans	$176 - $720	165%
Christian Hlthcare - All Plans	$498 - $640	466%
Cigna	$560 - $635	524%
First Choice Health - All Plans	$560 - $720	524%
Humana	$560 - $745	524%
Interwest Health Ppo - All Plans	$572 - $737	536%
First Health Ntwrk-All Plans	$578 - $745	541%
Three Rivers - All Plans	$591 - $761	553%
UnitedHealthcare	$591 - $745	553%
Rocky Mtn Admin - All Plans	$720	674%

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 $605.
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 Cody Regional Health 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.