Ultrasound, pelvis
Facility: Minneola District Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $134
- Cash Discount Price: $135
- vs. Medicare Baseline: 1.25x 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.
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 | $31 - $170 | 29% |
| Va Community Care Program-All Plans | $31 - $114 | 29% |
| Humana | $31 - $114 | 29% |
| Medicaid / KanCare | $84 - $170 | 79% |
| Aetna | $84 - $170 | 79% |
| Providrs Care Network-All Plans | $84 - $144 | 79% |
| Blue Cross Blue Shield | $123 | 115% |
| Corporate Plan Management-All Plans | $144 | 135% |
| Triwest-All Plans | $153 | 143% |
| Preferred Health Care (Coventry)-All Other Plans | $153 | 143% |
| Phc (Coventry) Leased Network | $162 | 152% |
| Health Partners Of Kansas-All Plans | $162 | 152% |
Consumer Guidance & Cost Commentary
For an ultrasound of the pelvis at Minneola District Hospital, the cash median price is $135.00, which is lower than the facility's negotiated rates of $153.00 and the state average of $134.00. While commercial payers like UnitedHealthcare and Humana negotiate rates ranging from $31 to $170, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated amounts often exceed the cash price. Because this facility is a Critical Access Hospital in Kansas, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing administrative fees associated with insurance claims.
It is important to understand that commercial insurance rates are not always the lowest possible option; in fact, the median negotiated rate of $153.00 is higher than the cash price, illustrating that insurance contracts can sometimes result in higher costs for the patient. Medicare serves as a reliable benchmark for fair pricing, with the Medicare amount for this procedure set at $106.81, indicating that the facility's cash rate is already competitive relative to federal standards. To avoid unexpected charges, patients should request a full itemized bill rather than accepting a summary invoice, ensuring that no services were unbundled or incorrectly charged, and should be aware that federal protections like the No Surprises Act may prevent balance billing for out-of-network services at in-network facilities.