Ultrasound, abdomen (complete)
Facility: Fredonia Regional Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $273
- Cash Discount Price: $304
- vs. Medicare Baseline: 2.56x 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 256% of the Medicare baseline (a markup of 156%). 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 | $150 - $152 | 140% |
| Aetna | $155 - $273 | 145% |
| UnitedHealthcare | $155 - $273 | 145% |
| Veterans Programs - All Plans | $155 | 145% |
| Cigna | $273 | 256% |
| Reserve National-All Plans | $273 | 256% |
| Meritain-All Plans | $273 | 256% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Fredonia Regional Hospital in Kansas, the cash price is $304.00, which matches the facility's median negotiated rate of $273.00 and the median paid amount. While commercial payers like Aetna and UnitedHealthcare negotiate rates ranging from $155 to $273, the cash price remains the highest figure in this dataset. It is important to note that for patients with high-deductible plans, paying the cash price of $304.00 upfront can sometimes be more cost-effective than relying on insurance, as the insurer's allowed amount may exceed the cash rate. Additionally, patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts, which could reduce the final bill if paid in full before or shortly after the service.
The facility's pricing is benchmarked against the federal Medicare rate of $106.81, which serves as the objective baseline for evaluating hospital markups. Commercial rates often average between 200% and 300% of the Medicare amount, though fair pricing is typically defined as 120% to 150% of this baseline. In this case, the gross charge of $304.00 represents a significant markup over the Medicare rate. To avoid unexpected costs, consumers should request an itemized bill to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. If a balance bill arises from an out-of-network ancillary service, patients should dispute the charge with their insurer rather than paying immediately, as the No Surprises Act protects against such billing for emergency and