Ultrasound, pelvis
Facility: Scott County Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $688
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 6.44x 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 644% of the Medicare baseline (a markup of 544%). 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 | $60 - $726 | 56% |
| Blue Cross Blue Shield | $123 | 115% |
| Humana | $321 | 301% |
| Wppa | $458 - $1,200 | 429% |
| Aetna | $688 | 644% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at Scott County Hospital, the commercial negotiated rates range from $60 to $1,200 across five insurance plans, with a median negotiated amount of $688. This facility is a Critical Access Hospital in Scott City, Kansas, and its pricing is significantly higher than the state average, which is 6.4 times the Medicare benchmark rate of $106.81. While commercial contracts often include administrative overhead that can inflate prices by 20% to 40%, it is important to note that cash-pay options may offer a lower total cost for patients with high-deductible plans, provided the facility offers a self-pay or prompt-pay discount.
Patients should verify their specific plan details before scheduling, as in-network status does not guarantee the lowest possible price, and some facilities may charge significantly more than others. To minimize out-of-pocket expenses, we recommend contacting the hospital directly to inquire about self-pay rates or prompt-pay discounts, which can reduce bills by 20% to 50% when paid upfront. Additionally, if you have received a bill, request a full itemized statement to review every line item for potential errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written audit.