CMS Price Transparency Data

Ultrasound, pelvis

Facility: Via Christi Hospital Wichita St Teresa, Inc

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $99
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Via Christi Hospital Wichita St Teresa, Inc is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.93x the Medicare baseline. Located in 14800 West Teresa St, Wichita, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Insurance Median: $99 (93%)
Ins. Median: $99 (93% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Vc Hope $98 92%
Medicare (plans) $98 - $100 92%
Via Christi Research $98 92%
Va $98 92%
Saint Lukes Health Systems $98 92%
Humana $98 92%
Blue Cross Blue Shield $100 94%
UnitedHealthcare $100 - $275 94%
Corizon $123 115%
Smarthealth $138 129%
Medicaid / KanCare $167 156%
Coventry City Of Wichita $231 216%
Aetna $245 229%

Consumer Guidance & Cost Commentary

For the pelvic ultrasound procedure (CPT 76856) at Via Christi Hospital Wichita St Teresa, Inc., the negotiated rates range from $98 to $275 depending on your insurance plan, with a median negotiated amount of $99.00. This facility is a voluntary non-profit church-owned acute care hospital located in Wichita, Kansas. While specific cash and median paid values are not available in the current data, it is important to note that cash-pay options can sometimes be more affordable than insurance negotiated rates, particularly for patients with high-deductible plans where the insurer's allowed amount exceeds the cash price. Patients should always inquire directly with the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final cost by bypassing administrative billing cycles.

When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $106.81, which serves as an objective baseline for fair pricing. Commercial negotiated rates often average 200% to 300% of the Medicare rate, though fair pricing is typically defined as 120% to 150% of this baseline. Since the facility's negotiated rates start at $98, they are comparable to or slightly below the Medicare amount for this specific code, indicating a transparent pricing structure. Consumers should avoid accepting summary bills that obscure individual charges and instead request a full itemized statement to ensure no unbundled codes or services not rendered are included in the final invoice.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14800 West Teresa St, Wichita, KS 67235
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals