CMS Price Transparency Data

Ultrasound, pelvis

Facility: South Lincoln Medical Center - Cah

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $689
Cash Discount Price: $390
vs. Medicare Baseline: 6.45x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at South Lincoln Medical Center - Cah is $689. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.45x the Medicare baseline. Located in 711 Onyx Street, Kemmerer, WY.

Cash / Self-Pay

$390

Average discount available for prompt cash payment at this facility.

Insurance Median

$689

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: $390 (365%)

Insurance Median: $689 (645%)

Cash: $390 (365% of Medicare)

Ins. Median: $689 (645% 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 645% of the Medicare baseline (a markup of 545%). 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	$32 - $727	30%
Blue Cross Blue Shield	$32 - $643	30%
Humana	$32 - $398	30%
UnitedHealthcare	$38 - $689	36%
Health Infonet/First Choice - All Plans	$261 - $727	244%
Altius Health Plans - All Plans	$689	645%
Cigna	$689	645%
Great West Healthcare - All Plans	$689	645%
Integrated Hp - All Plans	$689	645%
Winhealth Partners - All Plans	$689	645%
Ccn - All Plans	$727	681%
Geha - All Plans	$727	681%
Three Rivers - All Plans	$727	681%

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 $390.
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 South Lincoln Medical Center - Cah 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.