CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mercy Hospital Kingfisher, Inc

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $471
  • Cash Discount Price: $589
  • vs. Medicare Baseline: 4.41x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mercy Hospital Kingfisher, Inc is $471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $589. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.41x the Medicare baseline. Located in 1000 Hospital Drive, Kingfisher, OK.
Cash / Self-Pay
$589

Average discount available for prompt cash payment at this facility.

Insurance Median
$471

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: $589 (551%)
Insurance Median: $471 (441%)
Cash: $589 (551% of Medicare)
Ins. Median: $471 (441% 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 441% of the Medicare baseline (a markup of 341%). 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.

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
Aetna $61 - $620 57%
Humana $61 - $382 57%
Medicaid / KanCare $61 - $272 57%
Health Choice Contracted [320166] $239 224%
Ambetter / Centene $272 255%
Home State Health Plan Contracted [320187] $272 255%
Novasys Contracted [320285] $272 255%
Webtpa Contracted [320417] $381 357%
Blue Cross Blue Shield $382 - $498 358%
Cherokee Nation Health Serv Contracted [320066] $382 358%
Cross Timbers Hospice [20098] $382 358%
Dept Of Veteran Affairs Contracted [320106] $382 358%
Elara Caring Aspire Hospice Contracted [320433] $382 358%
Elara Caring Aspire Hospice [20433] $382 358%
Halo Hcr Inc Hospice Contracted [320432] $382 358%
Halo Hcr Inc Hospice [20432] $382 358%
Independent Health [20197] $382 358%
Indian Health Service Contracted [320198] $382 358%
Kindful Hospice Contracted [320434] $382 358%
Kindful Hospice [20434] $382 358%
Medical Associates Health [20444] $382 358%
Medicare (plans) $382 - $643 358%
Mercy Hospice Okc [20252] $382 358%
Provider Partners Health Plans Contracted [320450] $382 358%
Qual Choice Contracted [320325] $382 358%
Tricare $382 358%
UnitedHealthcare $382 - $632 358%
Globalhealth Contracted [320145] $390 365%
Cigna $394 - $616 369%
Aither Health Contracted [320449] $544 - $770 509%
Mercy Benefit Admin Contracted [320251] $544 - $770 509%
Quik Trip Contracted [320447] $544 509%
Show-Me Health Administrators Contracted [320483] $544 509%
Benefit Management Contracted [320052] $589 - $680 551%
United Medical Resources Contracted [320454] $632 592%
Osma Health Contracted [320292] $634 594%
Medica Contracted [320239] $643 602%
Healthcare Highways Plus Contracted [320175] $680 637%
First Health Contracted [320128] $708 663%
Auxiant Contracted [320462] $770 721%
Ebms Contracted [320493] $770 721%
Healthlink Contracted [320179] $770 721%
Imagine 360 Contracted [320494] $770 721%
Reflect Health Contracted [320492] $770 721%
Yuzu Health Contracted [320521] $770 721%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Hospital Drive, Kingfisher, OK 73750
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals