Ultrasound, abdomen (limited)
Facility: Medicine Lodge Memorial Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $272
- Cash Discount Price: $286
- vs. Medicare Baseline: 2.55x 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 255% of the Medicare baseline (a markup of 155%). 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 |
|---|---|---|
| Tricare | $229 | 214% |
| Humana | $260 | 243% |
| Aetna | $265 - $286 | 248% |
| UnitedHealthcare | $272 | 255% |
| Hpk-All Plans | $272 | 255% |
| Medicaid / KanCare | $286 | 268% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure, the cash price of $286.00 is the lowest rate available, while the median negotiated rate across insurance plans is $272.00. This means that for patients with high-deductible plans, paying cash upfront could actually result in a lower out-of-pocket cost than using insurance, as the negotiated rate exceeds the cash price. It is important to verify your specific plan's deductible status before scheduling, as you may still be responsible for the full $272.00 if you have not yet met your annual deductible. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if the bill is settled in full within a short timeframe.
The facility's pricing is significantly higher than the Medicare benchmark, which stands at $106.81 for this service. While commercial rates often average 200% to 300% of Medicare, the negotiated rate here is approximately 2.5 times the Medicare amount. If you receive a surprise bill from an out-of-network provider, you may be eligible for protection under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. If you do receive an unexpected balance bill, do not pay immediately; instead, request a formal itemized audit to identify any errors, unbundled codes, or services not rendered, and dispute the charge in writing to avoid unnecessary debt.