CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Decatur Health

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $268
  • Cash Discount Price: $316
  • vs. Medicare Baseline: 2.51x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Decatur Health is $268. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $316. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.51x the Medicare baseline. Located in 810 W Columbia Street, Oberlin, KS.
Cash / Self-Pay
$316

Average discount available for prompt cash payment at this facility.

Insurance Median
$268

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: $316 (296%)
Insurance Median: $268 (251%)
Cash: $316 (296% of Medicare)
Ins. Median: $268 (251% 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 251% of the Medicare baseline (a markup of 151%). 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 $195 183%
Wppa/Providrs Care- All Plans $211 198%
UnitedHealthcare $214 - $268 200%
Humana $216 202%
Midlands Choice- All Plans $316 296%
Aetna $316 - $351 296%
Medicaid / KanCare $355 332%

Consumer Guidance & Cost Commentary

For the CPT code 76700, Ultrasound, abdomen (complete), Decatur Health in Oberlin, KS, lists a cash median price of $316.00, which is notably lower than the facility's gross charge of $351.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $214 to $351, the cash price can be a more economical option for patients with high-deductible plans or those without insurance, as it avoids the administrative markup inherent in insurance billing cycles. It is important to note that commercial negotiated rates often exceed cash prices due to the costs of claims processing and contract management, so patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.

Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still arise from ancillary services or if a patient inadvertently accepts a summary bill that obscures individual line items. To minimize costs, consumers are encouraged to request a full itemized CPT-coded bill before negotiating and to explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the final amount by 20% to 50% if paid in full upfront. Since over 80% of hospital bills contain errors, disputing any discrepancies in writing with the billing supervisor is a critical step in ensuring the final invoice accurately reflects the services rendered.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 810 W Columbia Street, Oberlin, KS 67749
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals