Ultrasound, pelvis
Facility: Kiowa County Memorial Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $156
- Cash Discount Price: $149
- vs. Medicare Baseline: 1.46x 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 |
|---|---|---|
| Blue Cross Blue Shield | $123 - $156 | 115% |
| UnitedHealthcare | $140 - $175 | 131% |
| Health Partners Of Ks-All Plans | $154 | 144% |
| Celtic Comml Exchange-All Other Plans | $156 | 146% |
| Medica Prime Mcare Cost-All Plans | $156 | 146% |
| Humana | $156 | 146% |
| Aetna | $156 | 146% |
| Medicaid / KanCare | $175 | 164% |
| Providrs Care/Wppa-All Plans | $262 | 245% |
Consumer Guidance & Cost Commentary
For the CPT code 76856, Ultrasound, pelvis, at Kiowa County Memorial Hospital in Greensburg, KS, the facility's cash price of $149.00 is lower than the Medicare benchmark of $106.81, indicating a markup of 1.5 times the federal baseline. While many commercial payers negotiate rates ranging from $123 to $262, the cash price often serves as a more affordable option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and contract structures that inflate commercial negotiated rates. Patients should verify if their specific plan falls within the 9 payers listed, noting that while UnitedHealthcare and Blue Cross Blue Shield have negotiated ranges starting at $123 and $140 respectively, the cash rate of $149.00 remains competitive and potentially lower than the highest negotiated amounts seen for this service.
To minimize costs, patients are encouraged to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Since over 80% of hospital bills contain errors, it is advisable to request a detailed, itemized statement rather than accepting a summary invoice, ensuring no unbundled codes or services not rendered are included. Although the facility is a Critical Access Hospital owned by the local government, the specific pricing for this ultrasound service should be compared against local county averages to confirm fairness, as commercial rates can vary significantly based on payer contracts and network tiers. Always confirm your deductible status before scheduling, as paying the full negotiated rate without meeting your