CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Good Samaritan Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $2,450
Cash Discount Price: $5,345
vs. Medicare Baseline: 22.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Good Samaritan Hospital is $2,450. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,345. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.94x the Medicare baseline. Located in 2425 Samaritan Drive, San Jose, CA.

Cash / Self-Pay

$5,345

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,450

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: $5,345 (5004%)

Insurance Median: $2,450 (2294%)

Cash: $5,345 (5004% of Medicare)

Ins. Median: $2,450 (2294% 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 2294% of the Medicare baseline (a markup of 2194%). 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
Santa Clara Family Health Plan	$72 - $1,342	67%
Physicians Medical Group	$82	77%
Blue Cross Blue Shield	$91 - $628	85%
Cigna	$156 - $5,649	146%
United	$245 - $1,801	229%
Medcare Partners	$544 - $1,059	509%
Blue Shield	$790	740%
Nx Health Network	$2,178 - $4,237	2039%
Sutter Select	$2,178 - $4,237	2039%
Multiplan	$2,359 - $5,649	2209%
Humana	$2,541 - $4,943	2379%
First Health	$2,758 - $7,061	2582%
Healthsmart	$2,903 - $6,002	2718%
Intercontinental Corporation	$2,903 - $5,649	2718%
Pha Pacific Health Alliance	$2,903 - $5,649	2718%
Ppo Next	$2,903 - $5,649	2718%
Aetna	$4,973 - $5,074	4656%

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 $5,345.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Good Samaritan Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76700.
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.