Ultrasound, pelvis
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 76856 (CPT)
- CPT Billing Code: 76856
- Insurance Median: $98
- Cash Discount Price: $808
- vs. Medicare Baseline: 0.92x 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.
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 | $27 - $275 | 25% |
| Medicaid / KanCare | $28 - $94 | 26% |
| Aetna | $28 - $94 | 26% |
| Providrs Care | $44 - $140 | 41% |
| Humana | $98 - $99 | 92% |
| Medicare (plans) | $98 - $100 | 92% |
| Va | $98 | 92% |
| Tricare | $99 | 93% |
| Blue Cross Blue Shield | $133 - $140 | 125% |
| Smarthealth | $138 | 129% |
| Ambetter / Centene | $167 | 156% |
Consumer Guidance & Cost Commentary
For this ultrasound procedure at Ascension Via Christi Hospital Manhattan, Inc, the cash price is $808.00, which is significantly lower than the facility's gross charge of $2,019.00. While commercial insurance plans like UnitedHealthcare and Medicaid/KanCare have negotiated rates ranging from $27 to $275, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying the cash rate directly. The facility's cash rate of $808.00 is also notably higher than the state of Kansas average for this service, suggesting that while the cash price is lower than the hospital's list charge, it remains above the typical cost for this procedure in the region.
The Medicare benchmark for this code is $106.81, providing a clear baseline for evaluating the facility's pricing structure. The facility's negotiated rate of $98.00 is very close to the Medicare amount, indicating a pricing model that aligns closely with federal cost standards rather than the inflated chargemaster. Patients should be aware that while in-network insurance plans offer protection against balance billing, the actual amount paid depends heavily on individual plan deductibles and co-pays. To ensure the most favorable outcome, patients are encouraged to request a prompt-pay discount or self-pay rate before scheduling, as paying upfront can sometimes bypass administrative fees and result in a lower final bill than the standard negotiated rate.