Ultrasound, pelvis
Facility: Kosciusko Community Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $218
- Cash Discount Price: $107
- vs. Medicare Baseline: 2.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 204% of the Medicare baseline (a markup of 104%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Amish Aid | $54 - $478 | 51% |
| Self Pay | $54 - $887 | 51% |
| Lutheran Preferred Network | $82 - $1,819 | 77% |
| Physicians Health Plan | $95 - $1,048 | 89% |
| One Call Care Diagnostics Wc | $98 | 92% |
| Veterans Eval Services | $98 | 92% |
| Php Freedom Network | $100 - $878 | 94% |
| UnitedHealthcare | $101 - $1,196 | 95% |
| Encore | $103 - $910 | 96% |
| Trma Inc | $103 - $1,023 | 96% |
| Tricare | $105 | 98% |
| Aetna | $106 - $1,210 | 99% |
| Department Of Veterans Affairs | $111 | 104% |
| Blue Cross Blue Shield | $117 - $455 | 110% |
| Humana | $117 - $245 | 110% |
| Medicare (plans) | $117 | 110% |
| Mhs | $117 - $245 | 110% |
| Iu Health | $118 | 110% |
| Node Non Par Hospice Agree | $118 | 110% |
| Node Va | $118 | 110% |
| Node Devoted Health Mcr Adv | $119 | 111% |
| In Dept Of Correction | $123 | 115% |
| Node Pphp Mcr Adv | $124 | 116% |
| Us Department Of Labor | $148 | 139% |
| Connecticut General Life Insurance Company | $152 - $1,339 | 142% |
| Cigna | $163 - $1,437 | 153% |
| Lutheran Advanced Network | $178 | 167% |
| Lutheran Preferred | $178 - $237 | 167% |
| Caresource | $189 - $245 | 177% |
| Align In Work Comp | $190 | 178% |
| One Call Work Comp | $190 | 178% |
| First Health Network | $194 - $1,706 | 182% |
| Prime Health Services | $194 - $1,706 | 182% |
| Encore Work Comp In | $213 | 199% |
| Advantage Health | $214 - $1,887 | 200% |
| Private Healthcare Systems | $222 - $1,956 | 208% |
| Sagamore | $227 - $2,138 | 213% |
| Managed Health Services Exchange | $237 | 222% |
| Workers Comp | $237 | 222% |
| Encore Health Network | $240 - $2,115 | 225% |
| Managed Health Services | $245 | 229% |
| Medicaid / KanCare | $245 | 229% |
| Encore Kba Epo | $284 | 266% |
| Encore Kba Ppo | $355 | 332% |