Ultrasound, pelvis
Facility: Mcpherson Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $96
- Cash Discount Price: $465
- 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 |
|---|---|---|
| UnitedHealthcare | $26 - $1,061 | 24% |
| Tricare | $27 - $85 | 25% |
| Aetna | $31 - $1,061 | 29% |
| Wellcare Mcr Adv - All Plans | $31 - $96 | 29% |
| Blue Cross Blue Shield | $31 - $96 | 29% |
| Humana | $31 - $96 | 29% |
| Ambetter / Centene | $31 - $111 | 29% |
| Healthy Blue Mcr Adv | $31 - $96 | 29% |
| Va Ccn - All Plans | $31 - $96 | 29% |
| Multiplan - All Plans | $38 - $955 | 36% |
| Medicaid / KanCare | $84 - $1,061 | 79% |
| Health Blue Mcaid - All Other Plans | $86 - $1,082 | 81% |
| Central Plains - All Plans | $146 - $796 | 137% |
| Medical Associates - All Plans | $146 - $796 | 137% |
| Cigna | $185 - $1,008 | 173% |
| Health Partners - All Plans | $185 - $1,008 | 173% |
| Wppa - All Plans | $743 | 696% |
| Christian Health Aid - All Plans | $849 | 795% |
| First Health - All Plans | $1,008 | 944% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at McPherson Hospital in Mcpherson, Kansas, the facility's cash median rate is $465.00, which is lower than the state average of $796.00. While many commercial payers negotiate rates ranging from $26 to $1,061, these negotiated amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $465.00 directly, as this avoids the higher negotiated fees that insurance carriers charge, provided the patient has not yet met their deductible. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates vary significantly even within the same facility.
To further reduce costs, patients should inquire about "self-pay" or "prompt-pay" discounts before check-in, which can lower the final bill by 20% to 50% by bypassing insurance billing cycles. Additionally, the facility's Medicare benchmark rate is $106.81, indicating that the cash price of $465.00 represents a markup relative to the federal government's cost-based standard. Since over 80% of hospital bills contain errors, consumers are encouraged to request a detailed, itemized statement to review specific CPT codes and identify any unbundled charges or services not rendered. Always dispute any balance bills or unexpected charges in writing to ensure accuracy and protect against surprise costs.