Ultrasound, pelvis
Facility: Cheyenne County Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $188
- Cash Discount Price: $198
- vs. Medicare Baseline: 1.76x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $122 | 114% |
| First Health - All Plans | $138 | 129% |
| UnitedHealthcare | $142 - $215 | 133% |
| Aetna | $142 - $188 | 133% |
| Tricare | $142 | 133% |
| Healthy Blue Mcr Adv | $142 | 133% |
| Choice Care - All Plans | $144 | 135% |
| Firstguard - All Plans | $158 | 148% |
| Wppa - All Plans | $178 | 167% |
| Cpm - All Plans | $188 | 176% |
| Preferred Hc - All Plans | $188 | 176% |
| Midlands Choice - All Plans | $192 | 180% |
| Ppo Next - All Plans | $194 | 182% |
| Health Partners - All Plans | $194 | 182% |
| Integrated Hp - All Plans | $194 | 182% |
| Unicare - All Plans | $194 | 182% |
| Childrens Mercy - All Plans | $198 | 185% |
| Healthy Blue Mcaid - All Other Plans | $198 | 185% |
| Healthwave Mcaid - All Plans | $198 | 185% |
| Providers Care-All Plans | $297 | 278% |
Consumer Guidance & Cost Commentary
For the CPT code 76856 (Ultrasound, pelvis), Cheyenne County Hospital's cash price of $198.00 aligns exactly with the facility's median negotiated rate of $198.00 and the cash median across payers. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 185% above the federal baseline. While commercial negotiated rates for this service range from $122 to $297 depending on the insurance plan, the facility's cash price remains consistent at $198.00. Given that the county average for this service is not explicitly provided in the data, patients should note that paying cash upfront may still be advantageous if their insurance plan's negotiated rate exceeds the cash price, as the facility offers no additional discount for self-pay beyond the listed amount.
Patients should verify whether "self-pay" or "prompt-pay" discounts are available before scheduling, as these programs can reduce costs by 20% to 50% for upfront payments. Although the facility is a Voluntary non-profit Critical Access Hospital located in St Francis, KS, and does not list a specific facility rating, the absence of a rating does not preclude the availability of these financial assistance options. To ensure you are receiving the most accurate pricing, request an itemized billing audit to confirm that all charges correspond to services rendered and that no unbundled codes or errors have inflated the total. Always confirm your deductible status and whether the facility is truly in-network for your specific plan, as in-network status does not guarantee the lowest possible price.