Ultrasound, abdomen (limited)
Facility: Stormont Vail Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $96
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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.
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 |
|---|---|---|
| Ambetter / Centene | $61 - $93 | 57% |
| UnitedHealthcare | $61 - $93 | 57% |
| Blue Cross Blue Shield | $62 - $532 | 58% |
| Aetna | $96 - $98 | 90% |
| Humana | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
This CPT code for an ultrasound of the abdomen at Stormont Vail Hospital in Topeka, KS, carries a gross charge of $1,045. While the facility's negotiated rates with major payers like UnitedHealthcare and Ambetter range between $61 and $93, the median amount paid by insurers is significantly higher at $25,529, likely due to the specific patient's deductible status or bundled services. It is important to note that cash-pay rates are not listed for this procedure; however, patients with high-deductible plans should verify if paying out-of-pocket upfront could result in a lower total cost, as commercial negotiated rates often exceed cash prices. Before scheduling, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if settled in full within 30 days, bypassing the administrative costs associated with insurance claims.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this code is $106.81, and the facility's negotiated rate of $96 represents a ratio of 0.9 relative to Medicare, indicating a pricing structure that aligns closely with federal cost baselines rather than commercial markups. Although the data does not provide specific county or state average comparisons for this exact code, understanding that commercial rates often include administrative overhead of 20% to 40% helps clarify why the allowed amount may differ from the base Medicare rate. If you receive a bill that seems excessive, request a detailed, itemized