Ultrasound, pelvis
Facility: Rehabilitation Hospital Of Overland Park
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $815
- Cash Discount Price: $1,087
- vs. Medicare Baseline: 7.63x 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 763% of the Medicare baseline (a markup of 663%). 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 | $652 | 610% |
| Americas Choice Provider Network | $761 | 712% |
| Velocity | $815 | 763% |
| Usa Managed Care Organization | $815 | 763% |
| Quiktrip Corporation | $815 | 763% |
| Provider Network Of America | $815 | 763% |
| Multiplan-Phcs | $869 | 814% |
| Prime Health Services | $924 | 865% |
| Medincrease | $978 | 916% |
Consumer Guidance & Cost Commentary
For the ultrasound of the pelvis at the Rehabilitation Hospital Of Overland Park, the cash price is $1,087.00, which matches the facility's cash median. While commercial insurance plans negotiate rates ranging from $652 to $978, these negotiated amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash rate directly more cost-effective than using insurance, especially if their deductible has not yet been met or if the insurance negotiated rate exceeds the cash price. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly by carrier and can sometimes be less favorable than self-pay options.
To ensure you are receiving the most accurate billing information, always request a full itemized bill before paying, as summary invoices can obscure individual charges or unbundled services. Additionally, ask the facility about "prompt-pay" discounts, which can reduce the final cost by 20% to 50% if you settle the bill upfront. While this specific service does not have a state or county average listed for comparison, understanding that Medicare rates serve as a baseline for fair pricing can help you evaluate the facility's charges; in this case, the Medicare amount is $106.81, highlighting the significant markup often found in commercial billing. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference for emergency care and non-emergency services at in-network facilities.