CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $176
  • Cash Discount Price: $935
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Mercy Specialty Hospital Southeast Kansas is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $935. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.65x the Medicare baseline. Located in 1619 K 66, Galena, KS.
Cash / Self-Pay
$935

Average discount available for prompt cash payment at this facility.

Insurance Median
$176

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%)
Cash / Self-Pay: $935 (875%)
Insurance Median: $176 (165%)
Cash: $935 (875% of Medicare)
Ins. Median: $176 (165% 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
Medicaid / KanCare $56 - $102 52%
Blue Cross Blue Shield $60 - $102 56%
Aetna $65 - $102 61%
Humana $65 - $104 61%
Provider Partners Health Plans Contracted [320450] $70 66%
First Health Contracted [320128] $74 69%
UnitedHealthcare $91 - $1,330 85%
Pace Of The Ozarks Contracted [320518] $102 95%
Mercy Hospice Okc [20252] $102 95%
Globalhealth Contracted [320145] $102 95%
Medicare (plans) $102 95%
Mercy Mgd Behavioral Health Contracted [320259] $102 95%
Cigna $102 - $467 95%
Kindful Hospice Contracted [320434] $102 95%
Medical Associates Health Contracted [320444] $102 95%
Halo Hcr Inc Hospice [20432] $102 95%
Qual Choice Contracted [320325] $102 95%
Elara Caring Aspire Hospice [20433] $102 95%
Tricare $102 95%
Cherokee Nation Health Serv Contracted [320066] $102 95%
Cross Timbers Hospice [20098] $102 95%
Halo Hcr Inc Hospice Contracted [320432] $102 95%
Kindful Hospice [20434] $102 95%
Dept Of Veteran Affairs Contracted [320106] $104 97%
Centivo Contracted [320505] $104 97%
United Medical Resources Contracted [320454] $155 - $322 145%
Providrs Care Network Contracted [320484] $197 184%
Insurance System Inc Contracted [320465] $322 301%
Healthscope Contracted [320182] $322 - $1,078 301%
Health Systems Inc Contracted [320174] $322 301%
Benefit Management Contracted [320052] $322 301%
Point C Contracted [320238] $322 - $1,078 301%
Show-Me Health Administrators Contracted [320483] $420 393%
Mercy Benefit Admin Contracted [320251] $420 - $1,007 393%
Medica Contracted [320239] $523 490%
Aither Health Contracted [320449] $1,007 943%
Yuzu Health Contracted [320521] $1,007 943%
Imagine 360 Contracted [320494] $1,007 943%
Auxiant Contracted [320462] $1,007 - $1,078 943%
Ebms Contracted [320493] $1,007 943%
Edison Health Solutions Contracted [320502] $1,007 943%
Reflect Health Contracted [320492] $1,007 943%
American Healthcare Alliance Contracted [320020] $1,007 943%
Healthlink Contracted [320179] $1,078 1009%
Federal Medical Center Contracted [320127] $1,078 1009%
Preferred Health Plan Contracted [320522] $1,078 1009%
Compcare Of The Ozarks Contracted [320437] $1,136 1064%
Workers Comp [20426] $1,150 1077%
Private Health Care Systems Contracted [320320] $1,330 1245%
Multiplan [20270] $1,366 1279%
Multiplan Contracted [320270] $1,366 1279%

Consumer Guidance & Cost Commentary

For the CPT code 76700, Ultrasound, abdomen (complete), Mercy Specialty Hospital Southeast Kansas lists a gross charge of $1,438.00, with a cash median price of $935.00 and a median negotiated rate of $176.00. While the facility is located in Galena, KS, the data provided does not include specific county or state average figures for comparison. However, the facility's cash price of $935.00 is significantly higher than the median paid amount of $94.00, illustrating the substantial administrative costs and markup inherent in insurance billing. Patients with high-deductible plans may find that paying the cash price of $935.00 upfront is more cost-effective than using insurance, as the negotiated rate often includes administrative fees that inflate the final bill. It is advisable to confirm with the hospital whether a "self-pay" or "prompt-pay" discount is available, which could further reduce the out-of-pocket cost.

The facility's pricing is benchmarked against Medicare, with a Medicare amount of $106.81. The commercial negotiated rates observed across various payers range widely, with the lowest at $56 for Medicaid/KanCare and the highest reaching $1,366 for certain contracted plans, reflecting the variability in network tiers and contract dynamics. Notably, the median paid amount of $94.00 is approximately 88% lower than the Medicare amount of $106.81, suggesting that for some payers, the actual reimbursement may be below the federal baseline. This disparity highlights the importance of verifying your specific plan's allowed amount

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1619 K 66, Galena, KS 66739
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals