CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Mercy Specialty Hospital Southeast Kansas

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $176
  • Cash Discount Price: $552
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Mercy Specialty Hospital Southeast Kansas is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. 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
$552

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: $552 (517%)
Insurance Median: $176 (165%)
Cash: $552 (517% 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 $20 - $102 19%
Humana $50 - $104 47%
Aetna $50 - $102 47%
Provider Partners Health Plans Contracted [320450] $53 50%
First Health Contracted [320128] $57 53%
Blue Cross Blue Shield $60 - $102 56%
UnitedHealthcare $91 - $785 85%
Qual Choice Contracted [320325] $102 95%
Halo Hcr Inc Hospice [20432] $102 95%
Elara Caring Aspire Hospice [20433] $102 95%
Kindful Hospice [20434] $102 95%
Kindful Hospice Contracted [320434] $102 95%
Mercy Mgd Behavioral Health Contracted [320259] $102 95%
Cigna $102 - $467 95%
Mercy Hospice Okc [20252] $102 95%
Cross Timbers Hospice [20098] $102 95%
Globalhealth Contracted [320145] $102 95%
Medical Associates Health Contracted [320444] $102 95%
Pace Of The Ozarks Contracted [320518] $102 95%
Cherokee Nation Health Serv Contracted [320066] $102 95%
Halo Hcr Inc Hospice Contracted [320432] $102 95%
Tricare $102 95%
Medicare (plans) $102 95%
Dept Of Veteran Affairs Contracted [320106] $104 97%
Centivo Contracted [320505] $104 97%
United Medical Resources Contracted [320454] $155 - $242 145%
Providrs Care Network Contracted [320484] $197 184%
Health Systems Inc Contracted [320174] $242 227%
Benefit Management Contracted [320052] $242 227%
Point C Contracted [320238] $242 - $637 227%
Insurance System Inc Contracted [320465] $242 227%
Healthscope Contracted [320182] $242 - $637 227%
Medica Contracted [320239] $309 289%
Yuzu Health Contracted [320521] $594 556%
Edison Health Solutions Contracted [320502] $594 556%
Mercy Benefit Admin Contracted [320251] $594 - $623 556%
Auxiant Contracted [320462] $594 - $637 556%
Reflect Health Contracted [320492] $594 556%
American Healthcare Alliance Contracted [320020] $594 556%
Aither Health Contracted [320449] $594 556%
Imagine 360 Contracted [320494] $594 556%
Ebms Contracted [320493] $594 556%
Show-Me Health Administrators Contracted [320483] $623 583%
Healthlink Contracted [320179] $637 596%
Preferred Health Plan Contracted [320522] $637 596%
Federal Medical Center Contracted [320127] $637 596%
Compcare Of The Ozarks Contracted [320437] $671 628%
Workers Comp [20426] $679 636%
Private Health Care Systems Contracted [320320] $785 735%
Multiplan Contracted [320270] $807 756%
Multiplan [20270] $807 756%

Consumer Guidance & Cost Commentary

For the CPT code 76705, Ultrasound, abdomen (limited), the gross charge at Mercy Specialty Hospital Southeast Kansas in Galena, KS is $849.00. While the facility offers a cash median price of $552.00, which is lower than the gross charge, the negotiated rates paid by insurance plans vary significantly, ranging from a low of $20 to a high of $807 depending on the payer. Notably, several major payers, including Medicaid/KanCare, Humana, and Aetna, have negotiated rates starting at $50, while others like UnitedHealthcare and Cigna have ranges extending up to $785 and $637 respectively. The Medicare benchmark for this service is $106.81, indicating that the cash price of $552.00 is approximately 5.1 times the Medicare rate, whereas the median negotiated rate across all payers is $176.00. Patients should be aware that while insurance plans provide a ceiling on charges, the actual amount paid to the patient often depends on their specific deductible status and plan coverage, which can result in out-of-pocket costs that exceed the cash price if the deductible has not been met.

To minimize potential costs, patients are encouraged to verify their specific plan's allowed amount before scheduling, as some commercial payers may negotiate rates higher than the cash price, making upfront payment a more economical option. The facility offers a prompt-pay discount for those who pay in full, which can reduce the bill by 20% to 50% and bypass the administrative overhead associated with insurance claims processing. Additionally, patients should

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