Ultrasound, abdomen (limited)
Facility: Cloud County Health Center
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $517
- Cash Discount Price: $262
- vs. Medicare Baseline: 4.84x 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 484% of the Medicare baseline (a markup of 384%). 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 |
|---|---|---|
| Mpi-All Plans | $31 - $528 | 29% |
| Aetna | $149 - $517 | 140% |
| Pponext-All Plans | $184 - $528 | 172% |
| Health Partners - All Plans | $528 | 494% |
Consumer Guidance & Cost Commentary
For the CPT code 76705, Ultrasound, abdomen (limited), the facility's cash median rate of $262.00 is significantly lower than the state of Kansas average, which sits at $517.00. While the facility's negotiated rate with most payers, including Aetna and Mpi-All Plans, averages $517.00, this figure aligns closely with the state median rather than representing a premium. It is important to note that for patients with high-deductible plans, paying the cash price of $262.00 upfront can be more cost-effective than relying on insurance, as the negotiated rate often exceeds the cash price. Additionally, patients should verify with the hospital for potential "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When evaluating the cost against federal benchmarks, the Medicare amount for this service is $106.81. The facility's cash rate of $262.00 represents roughly 2.4 times the Medicare amount, which falls below the typical commercial range of 200% to 300% of Medicare often seen in the industry. This suggests the facility is pricing competitively relative to the Medicare baseline. However, patients should be cautious of balance billing if they have out-of-network coverage, as the No Surprises Act protects against surprise bills for emergency care and non-emergency services at in-network facilities. To ensure accuracy, consumers are encouraged to request a detailed, itemized bill before payment to identify any errors or unbundled charges that may inflate the total cost.