Ultrasound, pelvis
Facility: Menorah Medical Center
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $197
- Cash Discount Price: $5,103
- vs. Medicare Baseline: 1.84x 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 |
|---|---|---|
| United | $60 - $2,296 | 56% |
| Amerigroup | $60 | 56% |
| Healthyblue | $61 | 57% |
| Medicaid / KanCare | $62 | 58% |
| Aetna | $62 - $2,602 | 58% |
| Unicare | $62 | 58% |
| Home State Health Plan | $95 | 89% |
| Multiplan | $100 - $3,776 | 94% |
| Corvel Corporation | $119 - $3,317 | 111% |
| Cigna | $122 - $4,082 | 114% |
| Oha Network | $124 - $2,551 | 116% |
| Blue Cross Blue Shield | $164 - $2,296 | 154% |
| Humana | $164 - $212 | 154% |
| Ambetter / Centene | $949 | 888% |
| Nhc Advantage | $970 | 908% |
| Wppa Providrs Care Network | $1,021 | 956% |
| Universal Healthcare | $1,786 | 1672% |
| Coventry | $2,051 | 1920% |
| Coventry Kc Mo | $2,092 | 1959% |
| College Park Family Care Center | $2,194 | 2054% |
| Cco, Inc. | $3,827 | 3583% |
| Focus Healthcare Mgmt, Inc | $3,827 | 3583% |
| Triwest Health Alliance | $3,827 | 3583% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Menorah Medical Center in Overland Park, KS, the cash price is $5,103, which aligns exactly with the facility's median paid amount. While many commercial payers have negotiated rates ranging from $60 to over $3,800 depending on the plan, the cash price remains the most transparent baseline for comparison. It is important to note that for patients with high-deductible plans, paying the cash price upfront can sometimes be more cost-effective than using insurance, as the negotiated rates for many carriers exceed the cash amount. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which are typically reductions of 20% to 50% offered when bills are settled in full within 30 days, bypassing the administrative costs associated with insurance claims processing.
When evaluating the cost relative to the broader healthcare landscape, the facility's cash rate of $5,103 is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 1.8 times the federal rate. This disparity highlights that commercial negotiated rates often include administrative overhead and contract dynamics that drive prices well above the true cost of care. To ensure you are receiving the best possible rate, it is advisable to request a detailed, itemized bill before finalizing payment to identify any unbundled codes or services not rendered. Furthermore, if you are using insurance, be aware that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, but you should still verify your specific plan's allowed amount and deductible status before scheduling to avoid unexpected out-of-pocket expenses.