Ultrasound, abdomen (limited)
Facility: Rooks County Health Center
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $631
- Cash Discount Price: $526
- vs. Medicare Baseline: 5.91x 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 591% of the Medicare baseline (a markup of 491%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $133 | 125% |
| Celtic Mcr Adv | $329 | 308% |
| Veterans Admin - All Plans | $329 | 308% |
| Tricare | $329 | 308% |
| Celtic Comm - All Other Plans | $362 | 339% |
| Aetna | $631 | 591% |
| Preferred Benefits Admin | $631 | 591% |
| UnitedHealthcare | $631 | 591% |
| Preferred Hlthcare - All Other Plans | $666 | 624% |
| Health Partners - All Plans | $666 | 624% |
| Healthy Blue Mcaid - All Plans | $701 | 656% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure code 76705 at Rooks County Health Center in Plainville, KS, the facility's cash median rate is $526.00, which is lower than the commercial negotiated rates of $631.00 paid by most major payers. While the facility is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash rate. To maximize savings, consumers should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if settled upfront.
It is important to note that the commercial negotiated rate of $631.00 is significantly higher than the Medicare benchmark of $106.81, reflecting the standard markup found in commercial contracts. If a patient receives care from an out-of-network provider or encounters unexpected ancillary services, they could face balance billing for the difference between the full chargemaster and the insurance allowed amount, though the No Surprises Act provides protections for emergency and non-emergency services at in-network facilities. To avoid errors or double-charging, patients should request a full itemized bill before making any payments, ensuring that all charges are accurate and that no services were rendered but billed.