Ultrasound, pelvis
Facility: Kiowa District Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $333
- Cash Discount Price: $282
- vs. Medicare Baseline: 3.12x 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 312% of the Medicare baseline (a markup of 212%). 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 | $122 | 114% |
| Tricare | $137 | 128% |
| Healthchoice-All Plans | $224 | 210% |
| UnitedHealthcare | $282 - $352 | 264% |
| Health Partners Of Ks-All Plans | $310 | 290% |
| Humana | $318 | 298% |
| Gbs Insurance - All Plans | $331 | 310% |
| Multiplan-All Plans | $331 | 310% |
| Triwest-All Plans | $334 | 313% |
| Aetna | $334 | 313% |
| Medicare (plans) | $334 | 313% |
| Medicaid / KanCare | $352 | 330% |
| Providers Care (Wppa)-All Plans | $528 | 494% |
| Liberty Healthshare-All Plans | $568 | 532% |
Consumer Guidance & Cost Commentary
For the ultrasound of the pelvis at Kiowa District Hospital, the cash price is $282.00, which is lower than the facility's negotiated rates with most major payers. While the median negotiated rate across all insurers is $331.00, some plans like Blue Cross Blue Shield and Tricare pay exactly $122.00 and $137.00 respectively, indicating significant variation in how different insurance contracts are structured. Patients with high-deductible plans may find it financially advantageous to pay the cash price of $282.00 directly, as this amount is lower than the average negotiated rate of $333.00 and significantly below the gross charge of $352.00. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket might result in a lower total cost than having insurance process the claim first.
The facility, a Critical Access Hospital in Kiowa, KS, offers a cash-pay rate of $282.00, which serves as a baseline for potential savings. If you are concerned about balance billing or unexpected charges, remember that the No Surprises Act protects you from being billed the difference between the hospital's full charge and your insurance allowed amount for emergency services or non-emergency care at in-network facilities. Should you receive a bill that seems incorrect, you have the right to request an itemized audit to review every line item, code, and service rendered, as over 80% of hospital bills contain errors. Always ask the hospital about prompt-pay discounts before check-in, as paying in full upfront can often reduce the final amount further than the cash price listed,