CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Nemaha Valley Community Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $452
  • Cash Discount Price: $811
  • vs. Medicare Baseline: 4.23x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Nemaha Valley Community Hospital is $452. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $811. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.23x the Medicare baseline. Located in 1600 Community Dr, Seneca, KS.
Cash / Self-Pay
$811

Average discount available for prompt cash payment at this facility.

Insurance Median
$452

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: $811 (759%)
Insurance Median: $452 (423%)
Cash: $811 (759% of Medicare)
Ins. Median: $452 (423% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 423% of the Medicare baseline (a markup of 323%). 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.

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
Blue Cross Blue Shield $152 142%
Humana $396 371%
Va Ccn - All Plans $396 371%
Aetna $400 - $766 374%
Celtic Comm Exch - All Plans $436 408%
Partners Direct Health - All Plans $469 439%
Multiplan - All Plans $811 759%
Midlands Choice - All Plans $856 801%
Health Partners - All Plans $856 801%

Consumer Guidance & Cost Commentary

For the Ultrasound, abdomen (complete) service at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median rate of $811.00 is notably higher than the state average of $469.00, though it aligns closely with the cash median for other providers in the region. While commercial insurance plans like Aetna and Humana negotiate rates ranging from $396 to $766, these negotiated amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. To secure the lowest possible rate, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront before insurance claims are processed.

It is important to understand that the facility's gross charge of $901.00 represents the maximum list price, which is significantly inflated compared to the Medicare benchmark of $106.81. Commercial negotiated rates typically average 200% to 300% of Medicare, whereas fair pricing is generally defined as 120% to 150% of this federal baseline. If you receive a bill that includes unexpected charges beyond the negotiated amount, you may be facing balance billing, which is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. Before finalizing any payment, request a full itemized audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Community Dr, Seneca, KS 66538
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals