CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: William Newton Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $145
  • Cash Discount Price: $404
  • vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at William Newton Hospital is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $404. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.36x the Medicare baseline. Located in 1300 East Fifth Avenue, Winfield, KS.
Cash / Self-Pay
$404

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $404 (378%)
Insurance Median: $145 (136%)
Cash: $404 (378% of Medicare)
Ins. Median: $145 (136% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $126 - $145 118%
Triwest- All Plans $141 132%
UnitedHealthcare $145 - $363 136%
Ambetter / Centene $145 - $404 136%
Providrs Care Nexus $247 231%
Providrs Care - All Other Plans $282 264%

Consumer Guidance & Cost Commentary

For the CPT code 76705, Ultrasound, abdomen (limited), at William Newton Hospital in Winfield, KS, the cash price is $404.00, which matches the facility's gross charge and the median cash rate. This cash price is significantly higher than the state average for this service, as indicated by a ratio of 1.4 times the Medicare benchmark of $106.81. While commercial insurance plans like UnitedHealthcare and Ambetter / Centene have negotiated rates ranging from $145 to $404, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the full cash price of $404.00 upfront may result in lower out-of-pocket costs compared to the insurance negotiated rates, provided the patient's deductible has not been met.

Patients should verify their specific plan details before scheduling, as some in-network carriers may charge up to the full gross amount depending on the number of plans within their network. To potentially reduce costs, individuals should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can offer immediate fee reductions for upfront payment. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should request a formal itemized audit to identify errors before making any payments. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so any unexpected high bills should be disputed with the insurer rather than paid immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1300 East Fifth Avenue, Winfield, KS 67156
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals