Ultrasound, pelvis
Facility: Osborne County Memorial Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $529
- Cash Discount Price: $496
- vs. Medicare Baseline: 4.95x 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 495% of the Medicare baseline (a markup of 395%). 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 |
|---|---|---|
| UnitedHealthcare | $444 | 416% |
| Health Partners Of Kansas | $502 | 470% |
| Wppa | $555 | 520% |
| Blue Cross Blue Shield | $572 | 536% |
Consumer Guidance & Cost Commentary
For the CPT code 76856 (Ultrasound, pelvis) at Osborne County Memorial Hospital in Osborne, KS, the cash price is $496.00, which is lower than the facility's gross charge of $584.00. While the facility is a Critical Access Hospital owned by the local government, the data does not provide specific county or state average rates for this procedure, so a direct comparison to regional pricing benchmarks is not possible from this report. However, patients with high-deductible plans or those without insurance may find the cash price advantageous, as it is lower than the negotiated rates paid by major payers such as UnitedHealthcare ($444) and Health Partners Of Kansas ($502). It is important to note that while these negotiated amounts appear higher than the cash price, they represent the maximum allowed by insurers; patients should verify their specific plan's deductible status before assuming insurance will result in a lower out-of-pocket cost.
If you choose to pay out-of-pocket, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount due by 20% to 50% for upfront payment. This practice bypasses the administrative costs associated with insurance claims processing and ensures immediate liquidity for the hospital. Additionally, if you have insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, meaning you should only be responsible for your plan's allowed amount rather than the full chargemaster rate. To ensure accuracy, always request a detailed, itemized bill that lists specific CPT codes rather than accepting a summary invoice, as this