Ultrasound, pelvis
Facility: University Of Ks Hlth System Great Bend Campus
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $298
- Cash Discount Price: $164
- vs. Medicare Baseline: 2.79x 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 279% of the Medicare baseline (a markup of 179%). 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 |
|---|---|---|
| Workers Comp [503999901] | $98 | 92% |
| Ku Athletics [503200094] | $98 | 92% |
| UnitedHealthcare | $98 | 92% |
| Medicare (plans) | $100 | 94% |
| Allwell [503200078] | $101 | 95% |
| Blue Cross Blue Shield | $101 | 95% |
| Humana | $103 | 96% |
| Tricare | $103 | 96% |
| Triwest [503201703] | $103 | 96% |
| Centurion [5032000966] | $127 | 119% |
| Ambetter / Centene | $142 | 133% |
| Occunet [503999930] | $205 | 192% |
| Fort Hays State Student Athletes [5032000960] | $205 | 192% |
| 6 Degrees Health [503999050] | $244 | 228% |
| Hchsync Centrus Health Direct [503999916] | $247 - $288 | 231% |
| Advanced Medical Pricing Solutions [503301513] | $309 | 289% |
| Wppa [503200056] | $345 | 323% |
| Meritain Health [503200039] | $345 - $493 | 323% |
| Alt Wppa [5032000964] | $345 | 323% |
| Alt Carelon Behavioral Health [503200905] | $411 | 385% |
| National Assn Letter Carriers [503200019] | $493 | 462% |
| First Health [5032000110] | $493 | 462% |
| Aha-Healthcare Preferred [503200050] | $493 | 462% |
| Alt Meritain Health [503999911] | $493 | 462% |
| Allied National [503999937] | $493 | 462% |
| Cigna | $493 - $658 | 462% |
| Php [503200005] | $493 | 462% |
| Aetna | $493 | 462% |
| Correct Care Solutions [50311253] | $575 | 538% |
| Usa Managed Care [503999030] | $740 | 693% |
Consumer Guidance & Cost Commentary
For this ultrasound of the pelvis at the University of KS Health System Great Bend Campus, the cash price is $164, which is significantly lower than the facility's negotiated rates that range from $98 to $740 depending on the insurance plan. While Medicare covers $106.81 for this service, commercial payers like Cigna and Cigna have negotiated rates as high as $658, illustrating how insurance contracts can inflate costs compared to direct payment. Patients with high-deductible plans may find it financially advantageous to pay the $164 cash price upfront, as the insurance negotiated rates often exceed this amount. To secure the lowest possible cost, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by offering immediate liquidity incentives.
When reviewing your final invoice, ensure you request a detailed itemized bill rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Comparing the facility's pricing to the state average is essential for understanding the markup; here, the facility's cash rate is notably lower than the median negotiated rate of $299 paid by insurers. If you receive a balance bill for the difference between the insurer's allowed amount and the full charge, remember that the No Surprises Act protects you from these unexpected costs for emergency care and non-emergency services at in-network facilities. Always verify your deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket expenses than paying cash directly.