Ultrasound, pelvis
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $606
- Cash Discount Price: $443
- vs. Medicare Baseline: 5.67x 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 567% of the Medicare baseline (a markup of 467%). 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 |
|---|---|---|
| Black Lung [6055] | $606 | 567% |
| Web Tpa [2115] | $606 | 567% |
| Blue Cross Blue Shield | $606 | 567% |
| Hooray Health [8000] | $606 | 567% |
| Lucent Health [6000] | $606 | 567% |
| Healthcare Highways [2210] | $606 | 567% |
| Aetna | $606 | 567% |
| Oncology Patient Assistance Programs [2295] | $606 | 567% |
| Department Of Corrections [1340] | $738 | 691% |
| National Association Of Letter Carriers [1695] | $854 | 800% |
| Cigna | $854 | 800% |
| American Postal Workers Union [1070] | $854 | 800% |
| Healthpartners [1500] | $854 | 800% |
| Humana | $871 | 815% |
| First Health [1375] | $1,148 | 1075% |
| Administrative Concepts [1005] | $1,148 | 1075% |
| Multiplan [1680] | $1,148 | 1075% |
| American Healthcare [1055] | $1,148 | 1075% |
| Coventry Healthcare [1320] | $1,211 | 1134% |
| Ks Disability Determination [6090] | $1,477 | 1383% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at the University of Kansas Health System - St Francis Campus, the facility's cash price of $443.00 is significantly lower than the median negotiated rate of $1,477.00 paid by insurance plans. While the facility's negotiated rates average $606.00 across 20 payers, this amount remains higher than the cash price, which can be advantageous for patients with high-deductible plans who may not yet have met their out-of-pocket thresholds. It is important to note that the facility's cash rate is also lower than the state of Kansas average for this service, making self-pay a potentially more cost-effective option if you are eligible for a prompt-pay discount.
When comparing this service to the Medicare benchmark, the facility's cash price of $443.00 is 5.7 times the Medicare rate of $106.81, reflecting the standard markup structure in healthcare billing. Although the facility is a voluntary non-profit church-owned acute care hospital located in Topeka, KS, patients should verify their specific plan details before scheduling, as some in-network contracts may still result in higher costs than paying cash directly. To ensure you receive the best possible rate, we recommend contacting the hospital directly to confirm their self-pay or prompt-pay discount policies before your visit, as these upfront discounts can substantially reduce the final amount owed.