CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Hiawatha Community Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $574
  • Cash Discount Price: $737
  • vs. Medicare Baseline: 5.37x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Hiawatha Community Hospital is $574. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $737. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.37x the Medicare baseline. Located in 300 Utah Street, Hiawatha, KS.
Cash / Self-Pay
$737

Average discount available for prompt cash payment at this facility.

Insurance Median
$574

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: $737 (690%)
Insurance Median: $574 (537%)
Cash: $737 (690% of Medicare)
Ins. Median: $574 (537% 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 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.

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
Blue Cross Blue Shield $124 - $131 116%
UnitedHealthcare $273 - $633 256%
Aetna $273 - $596 256%
Humana $275 257%
Ambetter / Centene $327 306%
Centrus Health Direct - All Plans $553 518%
Oscar - All Plans $553 518%
Preferred Hlth - All Plans $663 621%
Cigna $700 655%
Wppa Providrs Care - All Plans $700 655%
Multiplan - All Plans $715 669%
Midlands Choice - All Plans $715 669%
Healthy Blue Mcaid - All Plans $737 690%

Consumer Guidance & Cost Commentary

For the CPT code 76705, "Ultrasound, abdomen (limited)," Hiawatha Community Hospital in Hiawatha, KS, lists a gross charge of $737.00. While the facility offers a cash median price of $737.00, commercial insurance plans typically negotiate lower rates, with the median negotiated amount being $574.00. It is important to note that for patients with high-deductible plans, paying the cash price directly can sometimes be more cost-effective than using insurance, as the insurer's allowed amount may exceed the cash rate. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which can further reduce the final bill if paid in full upfront.

When comparing this facility's pricing to broader benchmarks, the cash median of $737.00 is significantly higher than the Medicare benchmark of $106.81, reflecting the standard commercial markup. However, the median negotiated rate of $574.00 provides a more realistic expectation for insured patients. Consumers should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, unexpected charges can still occur from out-of-network ancillary services like labs or emergency physicians. To avoid these surprises, patients should request a full itemized bill before paying and dispute any errors formally in writing, as over 80% of hospital bills contain mistakes that can be corrected.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Utah Street, Hiawatha, KS 66434
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals