CMS Price Transparency Data

Ultrasound, pelvis

Facility: Lindsborg Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $940
  • Cash Discount Price: $1,386
  • vs. Medicare Baseline: 8.80x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Lindsborg Community Hospital is $940. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,386. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.80x the Medicare baseline. Located in 605 W Lincoln Street, Lindsborg, KS.
Cash / Self-Pay
$1,386

Average discount available for prompt cash payment at this facility.

Insurance Median
$940

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: $1,386 (1298%)
Insurance Median: $940 (880%)
Cash: $1,386 (1298% of Medicare)
Ins. Median: $940 (880% 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 880% of the Medicare baseline (a markup of 780%). 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
Blue Cross Blue Shield $38 - $122 36%
Tricare $931 872%
Coventry Mcr Adv $940 880%
Cigna $1,684 1577%
Coventry Comm-All Other Plans $1,783 1669%
UnitedHealthcare $1,783 1669%
Phcs Preferred-All Plans $1,842 1725%
Multiplan-All Plans $1,842 1725%
Health Partners -All Plans $1,882 1762%
Century Health-All Plans $1,882 1762%
Wppa-All Plans $1,882 1762%
Coventry Wc $1,882 1762%

Consumer Guidance & Cost Commentary

For the ultrasound procedure on the pelvis at Lindsborg Community Hospital, the cash price is $1,386, which is lower than the median negotiated rate of $1,684 paid by most insurance plans. This aligns with the general principle that cash-pay options can be more cost-effective for patients with high-deductible plans, as the insurance negotiated rates often exceed the cash price. The facility, a Critical Access Hospital in Lindsborg, KS, offers a cash rate that is 8.8% higher than the Medicare benchmark of $106.81, reflecting the standard markup for commercial services. To maximize savings, patients should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.

While the hospital's negotiated rates range from $38 for Blue Cross Blue Shield to $1,882 for other carriers, the cash price remains the most transparent baseline for comparison. It is important to note that the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but patients must still verify their specific plan details to avoid unexpected costs. Since over 80% of hospital bills contain errors, consumers are advised to request a full itemized CPT-coded bill rather than accepting a summary invoice, ensuring that all charges are accurate and unbundled codes are corrected. By comparing the facility's cash rate against the Medicare benchmark and actively seeking prompt-pay discounts, patients can make informed decisions that align with their financial situation.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 605 W Lincoln Street, Lindsborg, KS 67456
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals