Ultrasound, abdomen (limited)
Facility: Nemaha Valley Community Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $172
- Cash Discount Price: $353
- vs. Medicare Baseline: 1.61x 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 |
|---|---|---|
| Humana | $26 - $345 | 24% |
| Aetna | $26 - $667 | 24% |
| Va Ccn - All Plans | $26 - $345 | 24% |
| Celtic Comm Exch - All Plans | $28 - $380 | 26% |
| Partners Direct Health - All Plans | $29 - $408 | 27% |
| Blue Cross Blue Shield | $45 - $133 | 42% |
| Multiplan - All Plans | $52 - $706 | 49% |
| Health Partners - All Plans | $64 - $746 | 60% |
| Midlands Choice - All Plans | $68 - $746 | 64% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure code 76705 at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash median rate is $353.00, which is significantly higher than the state average of $275.00. While commercial insurance plans like Aetna and Health Partners have negotiated rates ranging from $52 to $746, these figures often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated amount could be substantially higher than the out-of-pocket cash cost. To secure the lowest possible price, it is recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
When comparing this service to Medicare, the facility's cash rate is 1.6 times the Medicare benchmark of $106.81, indicating a markup typical of commercial pricing models. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still review their itemized bills to ensure no unbundled charges or services not rendered are included. If a discrepancy is found, a formal written audit dispute should be sent to the billing supervisor rather than settling verbally. Ultimately, understanding the difference between the gross chargemaster, the Medicare baseline, and the actual cash or negotiated rates allows consumers to make informed decisions and avoid unexpected financial burdens.