CMS Price Transparency Data

Ultrasound, pelvis

Facility: Medicine Lodge Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $275
  • Cash Discount Price: $290
  • vs. Medicare Baseline: 2.57x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Medicine Lodge Memorial Hospital is $275. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $290. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.57x the Medicare baseline. Located in 710 N Walnut Street, Medicine Lodge, KS.
Cash / Self-Pay
$290

Average discount available for prompt cash payment at this facility.

Insurance Median
$275

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $290 (272%)
Insurance Median: $275 (257%)
Cash: $290 (272% of Medicare)
Ins. Median: $275 (257% of 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 257% of the Medicare baseline (a markup of 157%). 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $232 217%
Humana $264 247%
Aetna $268 - $290 251%
Hpk-All Plans $275 257%
UnitedHealthcare $275 257%
Medicaid / KanCare $290 272%

Consumer Guidance & Cost Commentary

For this ultrasound procedure at Medicine Lodge Memorial Hospital in Medicine Lodge, KS, the cash price is $290, which matches the facility's gross charge and the highest negotiated rate paid by Medicaid/KanCare. While the median negotiated rate across six payers is $275, patients with high-deductible plans may find paying the full cash price of $290 more cost-effective than relying on insurance, as commercial negotiated rates often exceed the cash price due to administrative overhead and contract structures. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, the cash rate remains the same as the gross charge, meaning no self-pay or prompt-pay discounts are reflected in this specific data point.

When evaluating the cost relative to state benchmarks, the Medicare amount for this service is $106.81, which serves as the objective baseline for fair pricing. Commercial negotiated rates typically range from 200% to 300% of the Medicare rate, whereas fair pricing is generally defined as 120% to 150% of this amount. In this case, the cash price of $290 represents approximately 2.7 times the Medicare rate, consistent with the 2.6x comparison provided in the data. Patients should be aware that balance billing is largely prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but they should still request an itemized bill to ensure no unbundled codes or services not rendered are included in the final charge.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 710 N Walnut Street, Medicine Lodge, KS 67104
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals