CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lee's Summit Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,051
Cash Discount Price: $4,914
vs. Medicare Baseline: 9.84x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lee's Summit Medical Center is $1,051. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,914. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.84x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.

Cash / Self-Pay

$4,914

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,051

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: $4,914 (4601%)

Insurance Median: $1,051 (984%)

Cash: $4,914 (4601% of Medicare)

Ins. Median: $1,051 (984% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 984% of the Medicare baseline (a markup of 884%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
United	$60 - $2,366	56%
Healthyblue	$61	57%
Aetna	$62 - $2,681	58%
Amerigroup	$62	58%
Medicaid / KanCare	$62	58%
Unicare	$62	58%
Home State Health Plan	$63	59%
Multiplan	$100 - $3,890	94%
Corvel Corporation	$119 - $3,417	111%
Cigna	$122 - $4,205	114%
Oha Network	$124 - $2,628	116%
Blue Cross Blue Shield	$164 - $2,260	154%
Humana	$164 - $212	154%
Ambetter / Centene	$850 - $978	796%
Nhc Advantage	$869 - $999	814%
Wppa Providrs Care Network	$914 - $1,051	856%
Universal Healthcare	$1,600 - $1,840	1498%
Coventry	$1,838 - $2,113	1721%
Coventry Kc Mo	$1,875 - $2,155	1755%
College Park Family Care Center	$1,966 - $2,260	1841%
Focus Healthcare Mgmt, Inc	$3,429 - $3,943	3210%
Cco, Inc.	$3,886 - $4,468	3638%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $4,914.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lee's Summit Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.