Ultrasound, abdomen (complete)
Facility: Ellsworth County Medical Center
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $324
- Cash Discount Price: $360
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 | $142 - $150 | 133% |
| Triwest -All Plans | $169 | 158% |
| Healthy Blue Mcr Adv | $169 | 158% |
| Va Ccn-All Plans | $169 | 158% |
| Humana | $169 - $342 | 158% |
| UnitedHealthcare | $234 - $360 | 219% |
| First Health - All Plans | $324 | 303% |
| Aetna | $324 | 303% |
| Cigna | $342 | 320% |
| Healthy Blue Mcaid- All Other Plans | $360 | 337% |
| Medicaid / KanCare | $360 | 337% |
| Coventry Mcaid-All Plans | $360 | 337% |
| Providers Care-Wppa-All Plans | $540 | 506% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, representing a complete abdominal ultrasound at Ellsworth County Medical Center in Ellsworth, Kansas, the facility's cash price is $360.00. This cash rate aligns exactly with the facility's negotiated rate for Medicaid and several other payers, such as Healthy Blue Mcaid- All Other Plans and Medicaid / KanCare. However, for patients with commercial insurance, the negotiated rates vary significantly; for instance, UnitedHealthcare pays up to $360.00, while Blue Cross Blue Shield pays as low as $142.00. Because commercial negotiated rates often exceed the cash price due to administrative overhead and contract structures, patients with high-deductible plans may find paying the full cash price of $360.00 more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible is not yet met.
The facility, a Critical Access Hospital, lists a facility rating of 2 and operates under proprietary ownership. While the data does not provide specific county or state average figures for this procedure, the wide variance in payer payments—from $142.00 for Blue Cross Blue Shield to $540.00 for Providers Care-Wppa-All Plans—highlights the importance of verifying your specific plan's allowed amount before scheduling. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To minimize costs, it is advisable to request a prompt-pay discount or self-pay rate directly from the billing department prior to