Ultrasound, pelvis
Facility: Kingman Healthcare Center
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $84
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.79x 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.
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 |
|---|---|---|
| Medicaid / KanCare | $84 | 79% |
| Healthy Blue | $84 | 79% |
| Aetna | $174 | 163% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure of the pelvis at Kingman Healthcare Center in Kansas, the median negotiated rate is $84.00, which aligns exactly with the lowest and highest rates reported by the three in-network payers: Medicaid/KanCare, Healthy Blue, and Aetna. This facility, a critical access hospital in Kingman (ZIP 67068), does not list a cash median or a gross charge in the current data, so direct comparisons to state or county averages for cash prices are not available. However, the median paid amount of $148.00 is significantly higher than the Medicare benchmark of $106.81, indicating a markup of 1.38 times the federal baseline. When evaluating costs, it is important to remember that commercial negotiated rates often include administrative overhead and contract terms that can inflate the price relative to the Medicare cost basis, which represents a more objective measure of the true cost of care.
Patients should be aware that while in-network rates provide protection against balance billing, they may not always be the lowest possible price. In cases where a patient has a high deductible and has not yet met their out-of-pocket maximum, paying the cash price directly could result in lower total costs if the facility offers a prompt-pay discount. Since the data does not disclose a specific cash median, we recommend contacting the hospital directly to inquire about self-pay rates or prompt-pay incentives, which can range from 20% to 50% off the billed amount. Additionally, if you are concerned about the $148.00 median paid figure, you may request an itemized billing audit to ensure there are no errors, double-billing, or unb