Ultrasound, abdomen (complete)
Facility: Hiawatha Community Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $574
- Cash Discount Price: $737
- vs. Medicare Baseline: 5.37x 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 537% of the Medicare baseline (a markup of 437%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $144 - $152 | 135% |
| Aetna | $273 - $596 | 256% |
| UnitedHealthcare | $273 - $633 | 256% |
| Humana | $275 | 257% |
| Ambetter / Centene | $327 | 306% |
| Oscar - All Plans | $553 | 518% |
| Centrus Health Direct - All Plans | $553 | 518% |
| Preferred Hlth - All Plans | $663 | 621% |
| Cigna | $700 | 655% |
| Wppa Providrs Care - All Plans | $700 | 655% |
| Midlands Choice - All Plans | $715 | 669% |
| Multiplan - All Plans | $715 | 669% |
| Healthy Blue Mcaid - All Plans | $737 | 690% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, Ultrasound, abdomen (complete), Hiawatha Community Hospital in Hiawatha, KS (ZIP 66434) lists a cash price of $737.00, which matches the facility's gross charge and the median paid by cash-paying patients. This cash rate is significantly higher than the state average for this procedure, indicating that commercial insurance members may face substantial out-of-pocket costs depending on their specific plan. While the facility is a Critical Access Hospital owned by a voluntary non-profit, the negotiated rates vary widely among payers, ranging from $144 with Blue Cross Blue Shield to $737 with Healthy Blue Medicaid. Patients with high-deductible plans might find it financially advantageous to pay the cash price directly, as the insurance negotiated rates for some carriers exceed the cash amount, potentially resulting in higher net costs after deductibles are applied.
To minimize unexpected expenses, consumers should verify their specific plan's allowed amount and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill. 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 must still review their itemized bills carefully to ensure no unbundled codes or services not rendered are included. Since over 80% of hospital bills contain errors, requesting a formal itemized audit is a critical step to identify discrepancies before signing any consent waivers or making payments. By comparing the facility's rates against the Medicare benchmark of $106.81, which represents the true cost baseline, patients can better understand the markup and