Ultrasound, pelvis
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $330
- Cash Discount Price: $412
- vs. Medicare Baseline: 3.09x 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 309% of the Medicare baseline (a markup of 209%). 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 |
|---|---|---|
| Direct Benefit-All Plans | $110 | 103% |
| UnitedHealthcare | $133 - $458 | 125% |
| Berkley Net-All Plans | $183 | 171% |
| Trustmark Health Benefits-All Plans | $202 | 189% |
| Aetna | $202 - $311 | 189% |
| Meritain Health-All Plans | $206 | 193% |
| Ambetter / Centene | $220 | 206% |
| Axa Equitable - All Plans | $252 | 236% |
| Pinnacol-All Plans | $256 | 240% |
| Medi-Share-All Plans | $261 | 244% |
| Presbyterian-All Plans | $279 | 261% |
| Kasb Work Comp - All Plans | $293 | 274% |
| The Kempton Group Admin-All Plans | $316 | 296% |
| Auxiant - All Plans | $321 | 301% |
| Gpha(Wppa)-All Other Plans | $321 | 301% |
| Wppa- All Plans | $325 | 304% |
| Sisco-All Plans | $330 | 309% |
| Emc-All Plans | $330 | 309% |
| Providers Care Network- All Plans | $330 | 309% |
| Gpha Employee Benefit Plan | $334 | 313% |
| Employee Benefit-All Plans | $344 | 322% |
| Regional Care(Wppa)-All Plans | $344 | 322% |
| Triangle-All Plans | $348 | 326% |
| First Health -All Plans | $348 | 326% |
| One Call Physician-All Plans | $353 | 330% |
| Blue Cross Blue Shield | $362 | 339% |
| Tricare | $366 | 343% |
| Christian Hospital Aid - All Plans | $366 | 343% |
| Humana | $394 | 369% |
| Cigna | $403 | 377% |
| Luminare Health- All Plans | $403 | 377% |
| Coresource-All Plans | $412 | 386% |
| Deseret Mutual(Uhis)-All Plans | $412 | 386% |
| Vaccn-All Plans | $421 | 394% |
| Wps Vapc-All Plans | $435 | 407% |
| Hma Llc-All Plans | $435 | 407% |
| Reserve National-All Plans | $435 | 407% |
| Medicaid / KanCare | $458 | 429% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at Satanta District Hospital, the cash price is $412.00, which is lower than the facility's median negotiated rate of $330.00 paid by most commercial insurers. This price transparency data shows that while the facility's gross charge is $458.00, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as many commercial payers negotiate rates that exceed the cash amount. The facility, a Critical Access Hospital in Satanta, KS, offers a prompt-pay discount for upfront payments, which can further reduce the final bill by bypassing administrative claim processing fees and collection costs.
The Medicare benchmark for this service is $106.81, providing a clear baseline for evaluating the facility's pricing structure. While the cash price of $412.00 is significantly higher than the Medicare rate, it remains below the gross charge and aligns with the median negotiated rate of $330.00 observed across the 38 payers listed. Patients should verify their specific plan details before scheduling, as some in-network members may face higher out-of-pocket costs if their deductible has not been met or if ancillary services trigger balance billing protections under the No Surprises Act. Always request a self-pay classification and prompt-pay discount prior to check-in to ensure you receive the most favorable rate available.