Ultrasound, abdomen (limited)
Facility: Smith County Memorial Hospital
Billing Code: 76705 (CPT)
- CPT Billing Code: 76705
- Insurance Median: $279
- Cash Discount Price: $297
- vs. Medicare Baseline: 2.61x 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 261% of the Medicare baseline (a markup of 161%). 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 | $116 | 109% |
| Medicaid / KanCare | $208 - $297 | 195% |
| Multiplan-All Plans | $267 | 250% |
| Wppa-All Plans | $279 | 261% |
| UnitedHealthcare | $282 | 264% |
| Health Partners Of Ks Ppo-All Plans | $282 | 264% |
| Midlands Choice-All Plans | $282 | 264% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure, Smith County Memorial Hospital has a cash price of $297.00, which matches the facility's negotiated rate for Medicaid and several other payers, while the median negotiated rate across all seven payers is also $279.00. The facility's cash price is identical to its gross charge, meaning there is no discount available for paying out-of-pocket at the listed rate. However, patients with high-deductible plans should verify if their specific insurance allows a lower allowed amount than the cash price, as paying cash can sometimes be cheaper if the insurer's negotiated rate exceeds the cash price. It is also recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims processing.
When evaluating this cost, it is important to compare the facility's rates against objective benchmarks rather than the hospital's inflated chargemaster list. The Medicare amount for this service is $106.81, and the facility's cash price is 2.6 times the Medicare rate, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. Because this is a Critical Access Hospital in Smith Center, KS, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services from out-of-network providers at in-network facilities under the No Surprises Act. If a patient receives a bill for the difference between the provider's rate and the insurance payment, they should dispute the charge in writing rather than paying immediately to avoid unexpected debt.