Ultrasound, pelvis
Facility: Kansas Medical Center Llc
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $96
- Cash Discount Price: $234
- 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| Indian Health | $87 | 81% |
| Tricare | $87 | 81% |
| Blue Cross Blue Shield | $96 - $118 | 90% |
| Humana | $96 | 90% |
| Medadv_Wellcare | $96 | 90% |
| Ambetter / Centene | $96 | 90% |
| Wppa | $156 | 146% |
| Aetna | $174 | 163% |
| United | $191 | 179% |
| Three_Rivers | $193 | 181% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Kansas Medical Center Llc in Andover, the cash price of $234 is significantly lower than the negotiated rates charged by most insurance plans, which range from $60 to $193 depending on the specific carrier. While the facility's cash rate is higher than the state average of $206, it remains below the gross charge of $389 and aligns closely with the median paid amount of $206. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $234 cost is often lower than the out-of-pocket maximums or copayments associated with using insurance for this service.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. It is important to avoid balance billing by ensuring the facility submits claims only for in-network services, and if unexpected charges arise, patients should request an itemized audit to verify that all services rendered match the charges listed. Additionally, comparing the facility's rates to the Medicare benchmark of $106.81 reveals that the cash price represents a reasonable market rate, whereas commercial negotiated rates often include administrative markups that exceed the true cost of care.