Ultrasound, pelvis
Facility: Jewell County Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $383
- Cash Discount Price: $302
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $343 | 321% |
| Aetna | $363 | 340% |
| Meritain - All Plans | $363 | 340% |
| UnitedHealthcare | $383 | 359% |
| Midlands Choice - All Plans | $383 | 359% |
| First Health - All Plans | $383 | 359% |
| Cigna | $383 | 359% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at Jewell County Hospital in Mankato, KS, the facility's negotiated rates for commercial payers are $383, which matches the median paid amount. This rate is significantly higher than the cash price of $302, illustrating that paying out-of-pocket can sometimes be more cost-effective for patients with high-deductible plans, as the insurance negotiated rate often exceeds the cash price due to administrative overhead. While the facility is a Critical Access Hospital with government local ownership, the data does not provide a specific county or state average for comparison, so patients should verify if this rate aligns with their local market expectations before scheduling.
Patients should be aware that the $383 rate represents a contractual ceiling for in-network coverage, meaning the hospital will not bill the full gross charge of $403. However, because the cash price is lower, individuals may save money by paying directly, provided they confirm the discount with the hospital prior to check-in to avoid automatic claims submission that could void the cash agreement. Additionally, under the No Surprises Act, patients are protected from balance billing for emergency care and non-emergency services at in-network facilities, ensuring they are not billed for the difference between the provider's list price and the insurance allowed amount.