Ultrasound, abdomen (limited)
Facility: Mercy Hospital Columbus
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $600
- Cash Discount Price: $537
- vs. Medicare Baseline: 5.62x 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 562% of the Medicare baseline (a markup of 462%). 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 |
|---|---|---|
| Medicaid / KanCare | $50 - $600 | 47% |
| Humana | $50 - $785 | 47% |
| UnitedHealthcare | $91 - $686 | 85% |
| Blue Cross Blue Shield | $91 - $600 | 85% |
| Medicare (plans) | $100 - $624 | 94% |
| Health Systems Inc Contracted [320174] | $355 | 332% |
| Insurance System Inc Contracted [320465] | $355 | 332% |
| Administrative Payor Contracted [320005] | $372 | 348% |
| Ambetter / Centene | $600 | 562% |
| Cherokee Nation Health Serv Contracted [320066] | $600 | 562% |
| Halo Hcr Inc Hospice Contracted [320432] | $600 | 562% |
| Pace Of The Ozarks Contracted [320518] | $600 | 562% |
| Indian Health Service Contracted [320198] | $600 | 562% |
| Elara Caring Aspire Hospice [20433] | $600 | 562% |
| Cross Timbers Hospice [20098] | $600 | 562% |
| Dept Of Veteran Affairs Contracted [320106] | $600 | 562% |
| Novasys Contracted [320285] | $600 | 562% |
| Globalhealth Contracted [320145] | $600 | 562% |
| Qual Choice Contracted [320325] | $600 | 562% |
| Kindful Hospice Contracted [320434] | $600 | 562% |
| Halo Hcr Inc Hospice [20432] | $600 | 562% |
| Mercy Hospice Okc [20252] | $600 | 562% |
| Kindful Hospice [20434] | $600 | 562% |
| Mercy Mgd Behavioral Health Contracted [320259] | $600 | 562% |
| Cigna | $600 | 562% |
| Provider Partners Health Plans Contracted [320450] | $600 | 562% |
| Home State Health Plan Contracted [320187] | $600 | 562% |
| Centurion Of Missouri [20459] | $600 | 562% |
| Aetna | $600 - $743 | 562% |
| Medical Associates Health Contracted [320444] | $600 | 562% |
| Tricare | $602 | 564% |
| Healthscope Contracted [320182] | $637 | 596% |
| Workers Comp [20426] | $661 - $702 | 619% |
| United Medical Resources Contracted [320454] | $686 - $785 | 642% |
| Medica Contracted [320239] | $740 | 693% |
| Healthlink Contracted [320179] | $743 - $785 | 696% |
| First Health Contracted [320128] | $743 | 696% |
| Preferred Health Plan Contracted [320522] | $743 | 696% |
| American Healthcare Alliance Contracted [320020] | $743 | 696% |
| Mercy Benefit Admin Contracted [320251] | $743 - $785 | 696% |
| Federal Medical Center Contracted [320127] | $743 | 696% |
| Usa Managed Care Org Contracted [320429] | $743 | 696% |
| Edison Health Solutions Contracted [320502] | $785 | 735% |
| Ppo Plus Contracted [320310] | $785 | 735% |
| Reflect Health Contracted [320492] | $785 | 735% |
| Private Health Care Systems Contracted [320320] | $785 | 735% |
| Aither Health Contracted [320449] | $785 | 735% |
| Yuzu Health Contracted [320521] | $785 | 735% |
| Benefit Management Contracted [320052] | $785 | 735% |
| Auxiant Contracted [320462] | $785 | 735% |
| Imagine 360 Contracted [320494] | $785 | 735% |
| Show-Me Health Administrators Contracted [320483] | $785 | 735% |
| 90 Degree Benefits Contracted [320436] | $785 | 735% |
| Ebms Contracted [320493] | $785 | 735% |
| Point C Contracted [320238] | $785 | 735% |
Consumer Guidance & Cost Commentary
For this ultrasound of the abdomen at Mercy Hospital Columbus, the facility's cash price of $537 is lower than the state average of $589, offering a potential savings for patients with high-deductible plans who may not have insurance coverage. While many commercial payers have negotiated rates starting at $600, these amounts often exceed the cash price due to administrative costs and contract structures; for instance, Medicaid/KanCare plans range from $50 to $600, and Humana plans range from $50 to $785. Patients should verify their specific plan's allowed amount before scheduling, as assuming that being in-network guarantees the lowest price can lead to paying significantly more than necessary. Additionally, since the facility is a voluntary non-profit critical access hospital, it is recommended to contact the billing department directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final cost.
The facility's negotiated rates for this service average $600, which is higher than the Medicare benchmark of $106.81, reflecting the typical markup found in commercial contracts. However, the cash price of $537 remains the most transparent baseline for comparison, as it does not include the multi-layered administrative fees inherent in insurance billing cycles. To avoid unexpected balance billing, patients should ensure they understand their deductible status before using insurance, as some plans may require the full negotiated rate even after meeting the deductible threshold. If a patient receives an itemized bill that includes charges for services not rendered or unbundled codes, they should request a formal audit to identify errors, as over 80% of hospital bills contain discrepancies that can be corrected.