Ultrasound, pelvis
Facility: Bob Wilson Memorial Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $845
- Cash Discount Price: $414
- vs. Medicare Baseline: 7.91x 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 791% of the Medicare baseline (a markup of 691%). 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 | $164 | 154% |
| Centura Employee Plan | $205 | 192% |
| UnitedHealthcare | $331 - $862 | 310% |
| Kansas Health | $331 | 310% |
| Medicare (plans) | $331 | 310% |
| Aetna | $331 - $827 | 310% |
| Humana | $331 | 310% |
| Multiplan | $931 - $962 | 872% |
| Health Partners Of Kansas | $972 | 910% |
| Wppa | $982 | 919% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at Bob Wilson Memorial Hospital in Ulysses, Kansas, the negotiated rates paid by insurance carriers range from $164 to $982, with a median negotiated amount of $845. This commercial rate is significantly higher than the facility's cash price of $414 and exceeds the Medicare benchmark of $106.81, which serves as the objective baseline for fair pricing. While the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients with high-deductible plans may find that paying the cash price directly is more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital about any "self-pay" or "prompt-pay" discounts available before scheduling.
To ensure you are not overcharged, it is recommended to request a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Since the facility's cash median of $414 is lower than the average commercial rates, paying upfront can result in substantial savings compared to the typical insurance allowed amount. If you receive a bill that appears inflated or includes unexpected charges, you should dispute the itemized statement in writing to the billing supervisor rather than settling verbally, and consider requesting a No Surprises Act audit if you believe you were balance billed for out-of-network ancillary services. Always confirm your deductible status before using insurance for shoppable tests,