Ultrasound, pelvis
Facility: Neosho Memorial Regional Medical Center
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $166
- Cash Discount Price: $390
- vs. Medicare Baseline: 1.55x 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 | $60 | 56% |
| Blue Cross Blue Shield | $147 - $166 | 138% |
| Tricare | $160 | 150% |
| Va_Ccn | $166 | 155% |
| Aetna | $166 | 155% |
| Medadv_Uhc | $166 | 155% |
| Humana | $166 | 155% |
| Medadv_Allwell | $166 | 155% |
| Medicare (plans) | $166 | 155% |
| Ambetter / Centene | $262 | 245% |
| Wppa_Providrscare | $432 | 404% |
| United | $433 | 405% |
| Cigna | $494 | 463% |
| Hpk | $494 | 463% |
| Coventry | $494 | 463% |
Consumer Guidance & Cost Commentary
For this ultrasound of the pelvis at Neosho Memorial Regional Medical Center in Chanute, KS, the facility's cash price of $390.00 is lower than the median negotiated rate of $166.00 paid by most major insurers, including Blue Cross Blue Shield, Tricare, and United. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance contracts often include administrative overheads that inflate the allowed amount above the actual cash price. If you have a high-deductible plan, paying the cash price of $390.00 upfront may result in lower out-of-pocket costs compared to your insurance paying its negotiated rate of $166.00 while you wait to meet your deductible. Additionally, the facility offers a prompt-pay discount for those who settle the bill immediately, which can further reduce the final amount owed.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $390.00 represents a significant increase over the Medicare rate, reflecting the specific cost structures and administrative fees associated with private insurance billing. Although the data does not provide explicit county or state average comparisons for this specific CPT code, the facility's location in Chanute (ZIP 66720) and its status as a Critical Access Hospital are relevant factors in understanding regional pricing dynamics. To ensure you are receiving the most accurate pricing, we recommend requesting an itemized bill to verify that no unbundled codes or services not rendered are included, and confirming with the billing department whether any self-pay or prompt-pay discounts apply before