Ultrasound, pelvis
Facility: St. Catherine Hospital - Garden City
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $231
- Cash Discount Price: $553
- vs. Medicare Baseline: 2.16x 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 216% of the Medicare baseline (a markup of 116%). 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 |
|---|---|---|
| Medicare (plans) | $62 - $72 | 58% |
| Kansas Health | $62 | 58% |
| Aetna | $62 - $870 | 58% |
| Humana | $62 - $72 | 58% |
| Cigna | $62 - $261 | 58% |
| UnitedHealthcare | $62 - $640 | 58% |
| Blue Cross Blue Shield | $62 - $242 | 58% |
| Kaiser | $62 - $477 | 58% |
| Devoted Health | $72 | 67% |
| Innovage | $72 | 67% |
| Direct To Employer | $162 - $693 | 152% |
| Centura Employee Plan | $205 | 192% |
| Peak Health | $218 - $675 | 204% |
| United Colorado Doctor'S Plan | $245 | 229% |
| Multiplan | $250 - $1,472 | 234% |
| Denver Health | $409 | 383% |
| Wpaa | $724 | 678% |
| Christian Health Aid | $827 | 774% |
| Health Partners Of Kansas | $1,003 | 939% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure of the pelvis at St. Catherine Hospital in Garden City, Kansas, the cash price is $553, which is significantly lower than the median negotiated rate of $231 and the state average of $1,383. While commercial insurance plans like Aetna and Multiplan may negotiate rates as high as $1,472, paying cash upfront can often result in substantial savings, especially for patients with high-deductible plans who may not yet have met their coverage thresholds. It is important to note that the facility's cash rate is also lower than the Medicare benchmark of $106.81, suggesting that the cash price reflects a specific negotiated or self-pay agreement rather than the standard federal reimbursement rate used for benchmarking.
Patients should verify their specific plan details before scheduling, as some commercial payers may have negotiated rates that exceed the cash price, making self-pay a more economical choice. Additionally, many facilities offer prompt-pay discounts for those who settle their bill in full within a short window, which can further reduce the final amount owed. To ensure you are receiving the most accurate pricing, always request an itemized bill that breaks down the specific CPT codes and unit costs, rather than accepting a summary invoice that may obscure individual charges. Given that over 80% of hospital bills contain errors, obtaining a detailed statement is the most effective way to identify any unbundled codes or services not rendered before payment.