Ultrasound, abdomen (complete)
Facility: Clara Barton Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $554
- Cash Discount Price: $431
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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% |
| 6 Degrees Health - All Plans | $431 | 404% |
| Wppa-All Plans | $493 | 462% |
| UnitedHealthcare | $554 | 519% |
| Phcs - All Plans | $554 | 519% |
| Aetna | $554 | 519% |
| Hlth Partners Of Ks-All Plans | $567 | 531% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, "Ultrasound, abdomen (complete)," Clara Barton Hospital in Hoisington, KS, lists a gross charge of $616.00. While the facility's cash median rate is $431.00, which is lower than the state average of $462.00, the negotiated rates for in-network payers range from $150 to $567.00. It is important to note that for patients with high-deductible plans, paying the cash price of $431.00 upfront may result in lower out-of-pocket costs compared to the negotiated rates charged by insurance carriers, as the administrative overhead and contract structures often inflate these commercial rates. Patients should verify their specific plan's deductible status and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can significantly lower the final bill.
This procedure is subject to federal protections under the No Surprises Act, which prohibits balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. If a patient receives care from an out-of-network provider, they are not legally required to pay the difference between the provider's chargemaster rate and the insurance allowed amount, and they should dispute any surprise bills immediately rather than accepting summary invoices. Additionally, since over 80% of hospital bills contain errors, patients should request a full itemized CPT-coded statement to identify unbundled codes or services not rendered before agreeing to any payment plan. The facility's Medicare benchmarking rate of $106.81 serves as a baseline for evaluating pricing, with commercial