Ultrasound, pelvis
Facility: Stevens County Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $180
- Cash Discount Price: $207
- vs. Medicare Baseline: 1.69x 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 |
|---|---|---|
| Humana | $77 | 72% |
| Aetna | $79 - $207 | 74% |
| Blue Cross Blue Shield | $117 - $123 | 110% |
| First Health - All Plans | $186 | 174% |
| Wppa - All Plans | $197 | 184% |
| Medicaid / KanCare | $207 | 194% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Stevens County Hospital in Hugoton, Kansas, the cash price is $207.00, which matches the facility's gross chargemaster rate. While commercial insurance plans like Aetna and Blue Cross Blue Shield have negotiated rates ranging from $79 to $207, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $207.00 directly, as this avoids the higher negotiated fees that insurers charge their members. It is important to note that the facility is a Critical Access Hospital with government-local ownership, and while the cash rate is the lowest available option, patients should always confirm self-pay or prompt-pay discounts with the hospital before scheduling to ensure they are not charged the full list price.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $207.00 represents a 1.7x multiplier of the Medicare rate, indicating the standard commercial pricing structure used at this location. Although the data does not provide specific county or state average comparisons for this code, the facility's ownership by the local government and its status as a Critical Access Hospital suggest that pricing may be influenced by regional cost structures and federal reimbursement guidelines. To avoid unexpected costs, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected through a formal audit dispute.