Us Exam Pelvic Complete: What It Costs and What's Fair

CPT 76856  · Medicare rate: $105  · National avg charge: $1,309  · BillKarma data from 17 providers

Reviewed 2026-04-05  · Pricing data year: 2026

Us Exam Pelvic Complete (CPT 76856) is a diagnostic imaging scan that gives physicians detailed views of internal structures without surgery. It is typically ordered to evaluate an injury, disease, or condition that cannot be fully assessed through a physical exam alone. The scan usually takes 15 to 60 minutes to complete.

Cost by Billing Grade

Grade Avg Hospital Charge Medicare Rate Est. Patient Cost* Hospitals
D $800 $105 $160 2
F $1,377 $105 $275 15

*Estimated patient cost assumes 20% coinsurance after deductible is met. Actual cost depends on your specific plan, deductible status, and network.

Cost Range Across Hospitals

Min: $519 Max: $2,570
Medicare: $105 Avg: $1,309
Grade A (≤2x Medicare) Grade B (2–3x) Grade C (3–5x) Grade D/F (5x+)

What This Procedure Typically Costs by Facility Type

Hospital
17 providers
$519 $2,570 | Avg: $1,309 (12.4x Medicare)

Find Providers Near You for This Procedure

Showing 10 lowest-markup providers nationally across hospitals, surgery centers, and imaging centers. Enter ZIP code to compare local providers side by side.

Provider Type Location Grade Charge Benchmark Markup
AdventHealth East Orlando Hospital Orlando, FL D $519 $105
Medicare OPPS
4.9x
AdventHealth Gordon Hospital CALHOUN, GA F $787 $105
Medicare OPPS
7.5x
AdventHealth Hendersonville Hospital Hendersonville, NC F $833 $105
Medicare OPPS
7.9x
AdventHealth Kissimmee Hospital Orlando, FL F $943 $105
Medicare OPPS
9.0x
AdventHealth Celebration Hospital CELEBRATION, FL F $943 $105
Medicare OPPS
9.0x
AdventHealth Orlando Hospital Tampa, FL F $943 $105
Medicare OPPS
9.0x
AdventHealth Rollins Brook Hospital LAMPASAS, TX F $969 $105
Medicare OPPS
9.2x
AdventHealth Ocala Hospital OCALA, FL D $1,082 $105
Medicare OPPS
10.3x
AdventHealth Daytona Beach Hospital Daytona Beach, FL F $1,189 $105
Medicare OPPS
11.3x
AdventHealth Palm Coast Hospital Tampa, FL F $1,219 $105
Medicare OPPS
11.6x

What Is a Fair Price for This Procedure?

Medicare pays $105 for Us Exam Pelvic Complete (CPT 76856). This rate is set by CMS based on the actual cost of delivering the procedure, including physician time, overhead, and equipment. It's the most reliable national benchmark for what the procedure is worth.

A hospital charging $210 (2x Medicare) or less earns an A billing grade — these are the most fairly priced facilities for this procedure. The national average charge is $1,309 (12.4x Medicare).

If your bill shows more than $316 (3x Medicare) for this procedure, it may be worth reviewing the charges carefully. Upload your bill to check →

Frequently Asked Questions

Why does Us Exam Pelvic Complete cost so much more at some hospitals than others?
Hospital charges for Us Exam Pelvic Complete (CPT 76856) vary dramatically—sometimes by 10x or more—because hospitals set their own gross charges independently. Medicare pays $105 for this procedure based on actual delivery costs, but hospitals are not required to match that rate. The national average charge is $1,309. Using a price transparency tool helps you find a fairly priced facility.
Can I shop around for Us Exam Pelvic Complete if my doctor ordered it?
Yes. As long as the same CPT code (76856) is billed, the ordering physician does not need to be at the same facility that performs the scan. You can call hospitals and freestanding imaging centers to ask for their cash price or expected out-of-pocket cost before scheduling. Freestanding imaging centers typically charge significantly less than hospital outpatient departments.
What should I do if I received a bill for Us Exam Pelvic Complete that seems high?
Compare the charge on your bill to the Medicare reference rate of $105. If the hospital billed more than $210 (two times Medicare), you may be able to negotiate. Request an itemized bill, check for duplicate charges, and ask whether a prompt-pay or financial hardship discount applies. You can also upload your bill to BillKarma for a free automated review.

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