Ultrasound, pelvis
Facility: Susan B Allen Memorial Hospital
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $554
- Cash Discount Price: $326
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 328% |
| Providrs Care | $757 | 709% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure on the pelvis at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $326.00, which is 5.2% higher than the state average. While the facility offers a median negotiated rate of $554.00 for UnitedHealthcare and $757.00 for Providrs Care, these insurance rates are significantly higher than the cash price. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as the negotiated rates exceed the out-of-pocket cost. To secure the lowest possible amount, it is recommended to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final bill.
The Medicare benchmark for this service is $106.81, providing a clear baseline for evaluating the facility's pricing structure. The cash rate of $326.00 represents a markup relative to this federal standard, which is calculated based on actual provider costs rather than inflated chargemaster lists. If you choose to use insurance, be aware that the negotiated rates include administrative overhead and contract dynamics that often result in higher costs than paying cash. To ensure you are not overcharged, always request an itemized bill before payment to verify that all services rendered are accurately coded and that no unbundled charges or errors exist, as over 80% of hospital bills contain discrepancies that can be corrected through a formal audit.