Ultrasound, abdomen (limited)
Facility: Phillips County Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $276
- Cash Discount Price: $259
- vs. Medicare Baseline: 2.58x 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 258% of the Medicare baseline (a markup of 158%). 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 | $133 - $247 | 125% |
| UnitedHealthcare | $244 - $305 | 228% |
| Health Partners-All Plans | $305 | 286% |
| Medicaid / KanCare | $305 | 286% |
Consumer Guidance & Cost Commentary
For the CPT code 76705, Ultrasound, abdomen (limited), Phillips County Hospital in Phillipsburg, KS, has a cash median price of $259.00, which is lower than the facility's negotiated rates of $276.00 and the highest allowed amount of $305.00 paid by UnitedHealthcare. While the facility is a Critical Access Hospital with government local ownership, patients should note that cash payments can sometimes be more cost-effective than using insurance if their plan has a high deductible, as the insurance negotiated rate of $247.00 (median paid) is still higher than the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying out-of-pocket may result in immediate savings compared to the administrative costs and potential deductibles associated with insurance claims.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing markups; commercial rates are often significantly higher due to administrative overhead and contract dynamics. Although the data does not provide specific state or county average comparisons for this exact code, patients should be aware of the risk of balance billing if they receive care from out-of-network providers, even at an in-network facility, where the provider could bill the difference between their full chargemaster rate and the insurance allowed amount. To avoid unexpected costs, consumers 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 through an audit. Additionally, asking the hospital about prompt-pay discounts before check-in can help bypass the costly insurance billing cycle and secure immediate liquidity benefits