Ultrasound, pelvis
Facility: Greenwood County Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $270
- Cash Discount Price: $255
- vs. Medicare Baseline: 2.53x 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 253% of the Medicare baseline (a markup of 153%). 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 |
|---|---|---|
| Triwest - All Plans | $114 | 107% |
| Blue Cross Blue Shield | $116 - $122 | 109% |
| UnitedHealthcare | $134 - $268 | 125% |
| Tricare | $134 | 125% |
| Choicecare Mcr Adv - All Plans | $134 | 125% |
| Integrated Health Plan - All Plans | $239 | 224% |
| First Health Ccn Network | $271 | 254% |
| Beech Street - All Plans | $271 | 254% |
| First Health - All Other Plans | $271 | 254% |
| Preferred Hs (Coventry) - All Plans | $287 | 269% |
| Principal Health Care Inc - All Plans | $303 | 284% |
| Amerigroup Mcaid-All Plans | $319 | 299% |
| Medicaid / KanCare | $319 | 299% |
| Providrs Care/Wppa - All Plans | $478 | 448% |
Consumer Guidance & Cost Commentary
This ultrasound procedure for the pelvis at Greenwood County Hospital in Eureka, Kansas, carries a gross charge of $319.00, which is significantly higher than the facility's cash median of $255.00 and the state average of $268.00. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance negotiated rates vary widely, ranging from $114 with Triwest to $478 with Providrs Care/Wppa. For individuals with high-deductible plans, paying the cash price of $255.00 upfront may result in lower out-of-pocket costs compared to insurance claims where the negotiated rate could exceed the cash amount, provided the patient's plan covers the service.
To ensure you receive the most accurate pricing, it is essential to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and potential errors. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days, bypassing the administrative overhead of insurance claims. Finally, while the Medicare benchmark for this service is $106.81, commercial rates are often marked up significantly; however, the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, so verify your specific plan details and any applicable waivers before scheduling.