Ultrasound, abdomen (limited)
Facility: Girard Medical Center
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $219
- Cash Discount Price: $375
- vs. Medicare Baseline: 2.05x 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 205% of the Medicare baseline (a markup of 105%). 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 | $131 - $219 | 123% |
| UnitedHealthcare | $219 - $594 | 205% |
| Kansas Superior Select-All Plans | $219 | 205% |
| Aetna | $219 - $1,094 | 205% |
| Humana | $219 | 205% |
| Medicare (plans) | $219 | 205% |
| Ambetter / Centene | $219 | 205% |
| Multiplan-All Plans | $578 | 541% |
| Uhhis-All Plans | $594 | 556% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure code 76705 at Girard Medical Center in Girard, Kansas, the facility's negotiated rates range from $219 to $594 depending on the insurance plan, with a median negotiated amount of $219. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting the typical administrative markup associated with commercial insurance contracts. While the facility is a Critical Access Hospital owned by a government authority, patients should be aware that their specific insurance plan determines the final out-of-pocket cost; for instance, Blue Cross Blue Shield plans pay a low of $131, whereas Aetna plans can pay up to $1,094 for the same service.
If you are paying out-of-pocket, the cash price of $375 is notably higher than the median negotiated rate of $219, meaning that using insurance may result in a lower total cost for most patients. However, if your insurance plan has a high deductible or you are self-pay, you might find that paying the cash price directly is more economical than waiting for insurance reimbursement, especially since the cash price is lower than the maximum negotiated rates charged by some carriers like Aetna. Before scheduling, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the bill by bypassing standard insurance billing cycles and administrative fees.