Ultrasound, abdomen (complete)
Facility: Nmc Health
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $313
- Cash Discount Price: $381
- vs. Medicare Baseline: 2.93x 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 293% of the Medicare baseline (a markup of 193%). 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 |
|---|---|---|
| Bluestem Pace | $101 | 95% |
| Blue Cross Blue Shield | $152 | 142% |
| Leading Age | $162 | 152% |
| Medicaid / KanCare | $162 | 152% |
| Aetna | $194 | 182% |
| Wppa | $299 | 280% |
| Occunet | $326 | 305% |
| Medincrease Health Plan | $354 | 331% |
| Samaritan Ministries International | $354 | 331% |
| Prime Health Services | $408 | 382% |
| UnitedHealthcare | $490 | 459% |
| Cigna | $517 | 484% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, Ultrasound, abdomen (complete), Nmc Health in Newton, KS, charges a gross amount of $544.00. The facility's cash median price is $381.00, which is significantly lower than the gross charge. While the data does not provide a specific state or county average for this procedure, the facility's negotiated rates for commercial payers range from $101 for Bluestem Pace to $517 for Cigna, with a median negotiated rate of $313.00. These negotiated amounts are generally higher than the cash price, illustrating that patients with high-deductible plans might find the cash rate of $381.00 more affordable than the insurance negotiated rate, provided they have not yet met their deductible.
The facility's pricing is benchmarked against the federal Medicare rate of $106.81, which serves as a baseline for fair cost. The gross charge of $544.00 represents a substantial markup compared to this federal standard. Patients should be aware that while the facility is an in-network Acute Care Hospital owned by a voluntary non-profit, the final cost depends heavily on their specific insurance plan. To minimize out-of-pocket expenses, it is advisable to confirm with the hospital's billing department regarding "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront. Additionally, patients should request an itemized bill to ensure all charges are accurate and to verify that no unnecessary services were included.