Ultrasound, abdomen (complete)
Facility: Smith County Memorial Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $343
- Cash Discount Price: $365
- vs. Medicare Baseline: 3.21x 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 321% of the Medicare baseline (a markup of 221%). 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 | 140% |
| Medicaid / KanCare | $256 - $365 | 240% |
| Multiplan-All Plans | $328 | 307% |
| Wppa-All Plans | $343 | 321% |
| Health Partners Of Ks Ppo-All Plans | $347 | 325% |
| UnitedHealthcare | $347 | 325% |
| Midlands Choice-All Plans | $347 | 325% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $365.00, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital owned by the local government, patients with high-deductible plans might find paying cash directly more affordable than using insurance, as the negotiated rates for in-network payers range from $328 to $365. It is important to note that commercial insurance rates often include administrative overhead and contract markups that can exceed the cash price; for instance, the median negotiated rate across payers is $343.00, which is slightly lower than the cash price but still reflects the cost of claims processing and utilization reviews. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes bypass the higher administrative costs associated with insurance billing cycles.
When evaluating the value of this service, it is essential to compare the facility's rates against the Medicare benchmark rather than the inflated chargemaster list. The Medicare allowed amount for this code is $106.81, and the facility's cash rate of $365.00 represents a significant markup relative to this federal baseline. This pricing structure highlights how commercial rates can differ substantially from the "true cost" of care established by CMS. If a patient receives care from an out-of-network provider at this facility, they should be aware of federal protections under the No Surprises Act, which generally prevents balance billing for emergency services and non-emergency services at in-network facilities. To ensure accuracy and avoid unexpected charges, patients should request a detailed, itemized bill