Ultrasound, abdomen (complete)
Facility: William Newton Hospital
Billing Code: 76700 (CPT)
- CPT Billing Code: 76700
- Insurance Median: $169
- Cash Discount Price: $470
- vs. Medicare Baseline: 1.58x 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 |
|---|---|---|
| Blue Cross Blue Shield | $144 - $169 | 135% |
| Triwest- All Plans | $164 | 154% |
| UnitedHealthcare | $169 - $423 | 158% |
| Ambetter / Centene | $169 - $470 | 158% |
| Providrs Care Nexus | $288 | 270% |
| Providrs Care - All Other Plans | $329 | 308% |
Consumer Guidance & Cost Commentary
For the CPT code 76700, representing a complete abdominal ultrasound at William Newton Hospital in Winfield, KS, the cash price is $470.00, which matches the facility's gross charge and the median amount paid by cash-paying patients. While the facility is a Critical Access Hospital with a government-local ownership structure, the negotiated rates vary significantly across payers, ranging from a low of $144 to a high of $470.00. Notably, the median negotiated rate of $169.00 is substantially lower than the cash price, suggesting that for patients with high-deductible plans, paying out-of-pocket may not be the most cost-effective option if their insurance allows a higher allowed amount than the cash rate. However, patients should verify their specific plan's allowed amount, as some commercial payers may negotiate rates that exceed the cash price, making direct payment potentially more expensive than using insurance.
To ensure you are receiving the best possible rate, it is important to understand that commercial insurance contracts often include administrative overhead that can inflate the baseline price by 20% to 40% compared to direct cash payments. If you choose to pay with insurance, be aware that balance billing could occur if you receive care from out-of-network providers, though the No Surprises Act protects you from such unexpected bills for emergency and non-emergency services at in-network facilities. Additionally, since over 80% of hospital bills contain errors, always request a full itemized CPT-coded bill before agreeing to pay, rather than accepting a summary invoice that obscures individual charges. Finally, do not assume that being in-network guarantees the lowest price; always ask the hospital