Ultrasound, pelvis
Facility: Labette Health
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $98
- Cash Discount Price: $256
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| Uhccp | $51 - $87 | 48% |
| Medicaid / KanCare | $61 - $98 | 57% |
| Healthy Blue | $61 - $93 | 57% |
| Aetna | $89 | 83% |
| Multiplan | $92 - $422 | 86% |
| Kansas Superior Select | $96 - $101 | 90% |
| Humana | $98 | 92% |
| Blue Cross Blue Shield | $98 - $123 | 92% |
| Wellcare | $98 | 92% |
| UnitedHealthcare | $98 - $432 | 92% |
| Montgomery County | $99 - $180 | 93% |
| Ambetter / Centene | $113 | 106% |
| Choicecare (First Health Network) | $447 | 419% |
| Health Partners Of Kansas, Inc | $447 | 419% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Labette Health in Parsons, KS, the facility's cash price of $256.00 is notably lower than the gross charge of $366.00 and significantly below the highest negotiated rates seen among payers, such as UnitedHealthcare and Choicecare (First Health Network), which range up to $447.00. While many commercial plans have negotiated rates between $51.00 and $123.00, the cash price remains competitive for patients with high-deductible plans or those without insurance, as paying upfront avoids the administrative overhead and potential balance billing associated with insurance claims. It is important to note that while the facility is in-network for many carriers, the cash rate may still be the most cost-effective option if your specific plan's negotiated rate exceeds $256.00, which appears to be the case for several payers listed.
The facility's pricing aligns closely with state and county benchmarks, with a cash median of $256.00 compared to a Medicare benchmark of $106.81, indicating a markup typical of local acute care hospitals. Although the facility is government-owned locally, the negotiated rates vary widely across the 14 payers, ranging from $51.00 for Uhccp to $447.00 for Choicecare (First Health Network). Patients should be aware that balance billing is generally prohibited for emergency services under the No Surprises Act, but it is possible for out-of-network ancillary services or non-emergency procedures to trigger unexpected charges if not carefully reviewed. To ensure you receive the best possible rate, we recommend requesting a prompt-pay discount