Ultrasound, abdomen (complete)
Facility: Holton Community Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $793
- Cash Discount Price: $717
- vs. Medicare Baseline: 7.42x 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 742% of the Medicare baseline (a markup of 642%). 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 | $150 | 140% |
| UnitedHealthcare | $507 - $956 | 475% |
| Aetna | $507 - $956 | 475% |
| Humana | $512 | 479% |
| Kansas Superior Select - All Plans | $517 | 484% |
| Preferred Health Professionals | $793 | 742% |
| Preferred Health Fn Select - All Other Plans | $793 | 742% |
| Preferred Health Freedom | $793 | 742% |
| Wppa Providers - All Plans | $908 | 850% |
| Medicaid / KanCare | $956 | 895% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, "Ultrasound, abdomen (complete)," Holton Community Hospital in Kansas has a gross charge of $956.00. While the facility's cash median price is $717.00, which is lower than the gross charge, the negotiated rates paid by major payers like UnitedHealthcare and Aetna range from $507 to $956. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures; therefore, patients with high-deductible plans may find paying the cash price of $717.00 directly more cost-effective than relying on insurance, especially if their deductible has not yet been met. Additionally, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating this cost, it is crucial to compare rates against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this service is $106.81, which serves as the objective baseline for fair pricing. Although the data provided does not include specific county or state average comparisons for this specific code, the significant difference between the Medicare rate and the facility's gross charge highlights the potential for high markups. To avoid unexpected balance billing, patients should request an itemized bill before payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If a balance bill arises from an out-of-network provider, the No Surprises Act may protect patients from paying the difference, and they should dispute any surprise charges immediately rather than accepting summary bills as final