Ultrasound, abdomen (limited)
Facility: Susan B Allen Memorial Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $554
- Cash Discount Price: $287
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 328% |
| Providrs Care | $757 | 709% |
Consumer Guidance & Cost Commentary
For the CPT code 76705, representing an ultrasound of the abdomen, Susan B Allen Memorial Hospital in El Dorado, KS, lists a cash median price of $287.00, which is notably lower than the facility's gross charge of $441.00. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are $350 and $757 respectively, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that commercial negotiated rates often include administrative overhead and can be significantly higher than the actual cost of care, so verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
This procedure's pricing should be viewed in the context of the broader healthcare landscape, where Medicare serves as a reliable benchmark for fair pricing. The Medicare amount for this service is $106.81, and the facility's cash rate of $287.00 represents a markup of 5.2 times the Medicare rate. While the data does not provide specific state or county average comparisons for this exact procedure, understanding that commercial rates frequently range between 200% and 300% of Medicare helps contextualize the facility's pricing. To ensure you receive the best possible rate, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront, bypassing the higher administrative costs associated with insurance billing.