CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Grossmont Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $791
Cash Discount Price: $879
vs. Medicare Baseline: 7.41x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Grossmont Hospital is $791. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $879. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.41x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$879

Average discount available for prompt cash payment at this facility.

Insurance Median

$791

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: $879 (823%)

Insurance Median: $791 (741%)

Cash: $879 (823% of Medicare)

Ins. Median: $791 (741% 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 741% of the Medicare baseline (a markup of 641%). 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
Health Net	$36 - $1,149	34%
Medicare (plans)	$164	154%
Medi-Cal	$176 - $938	165%
Aetna	$328 - $820	307%
Blue Cross Blue Shield	$348 - $938	326%
Community Health Group	$398 - $791	373%
Molina	$586	549%
UnitedHealthcare	$592 - $879	554%
San Diego Pace	$645	604%
Kaiser	$791 - $938	741%
California Health And Wellness	$797 - $1,055	746%
Epic Americas	$809	757%
Multiplan	$809	757%
Blue Shield	$820	768%
Managed Health Network	$879	823%
Allianz Global Assistance	$938	878%
Cigna	$938	878%

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 $879.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76705.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76705.
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.