Ultrasound, abdomen (limited)
Facility: Wamego Health Center
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $62
- Cash Discount Price: $453
- vs. Medicare Baseline: 0.58x 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 |
|---|---|---|
| UnitedHealthcare | $23 - $91 | 22% |
| Aetna | $24 - $94 | 22% |
| Medicaid / KanCare | $24 - $94 | 22% |
| Providrs Care | $38 - $116 | 36% |
| Tricare | $99 | 93% |
| Blue Cross Blue Shield | $172 - $181 | 161% |
Consumer Guidance & Cost Commentary
For the Ultrasound, abdomen (limited) procedure at Wamego Health Center, the cash median price is $453.00, which is significantly lower than the facility's gross charge of $1,132.00. While the facility is a Critical Access Hospital in Wamego, KS, and serves six payers including Medicaid/KanCare, the negotiated rates vary widely, ranging from $23 to $181 depending on the insurance plan. For patients with high-deductible plans, paying the cash price of $453.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates for many commercial payers like UnitedHealthcare and Aetna can exceed the cash amount. Patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these facilities often offer fee reductions of 20% to 50% for upfront payment, bypassing the administrative costs associated with insurance claims processing.
When comparing pricing against federal standards, the Medicare amount for this service is $106.81, and the facility's cash rate is approximately 4.2 times higher than the Medicare benchmark. This markup is common in commercial billing, where negotiated rates include administrative overhead and risk adjustments that are not present in the government's fixed reimbursement system. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their itemized bills to ensure no unbundled codes or services not rendered are included. If a patient receives a summary bill, they should demand a full itemized CPT-coded statement to identify any errors or double-charges