CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Adventist Health Clearlake

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $574
Cash Discount Price: $446
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Adventist Health Clearlake is $574. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.37x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$446

Average discount available for prompt cash payment at this facility.

Insurance Median

$574

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: $446 (418%)

Insurance Median: $574 (537%)

Cash: $446 (418% of Medicare)

Ins. Median: $574 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Blue Shield Mcr Adv	$113 - $299	106%
Kaiser Mcr Adv	$113 - $299	106%
Tricare	$113 - $299	106%
Blue Cross Blue Shield	$117 - $661	110%
Bc Managed Mcal	$119	111%
Medi-Cal	$119	111%
UnitedHealthcare	$124 - $1,186	116%
Ah Employee Health Plan - All Plans	$226 - $597	212%
Aetna	$401 - $1,063	375%
Western Growers- All Plans	$403 - $1,066	377%
Blue Shield Epn - All Other Plans	$412 - $1,092	386%
Blue Shield Non-Epn	$412 - $1,092	386%
First Health- All Plans	$430 - $1,138	403%
Healthnet- All Plans	$440 - $1,166	412%
Foundation- All Plans	$456 - $1,209	427%
Health Mgmt Network- All Plans	$456 - $1,209	427%
Humana	$456 - $1,209	427%
Phcs- All Plans	$456 - $1,209	427%
Cigna	$483 - $1,280	452%
Interplan- All Plans	$483 - $1,280	452%
Kaiser- All Other Plans	$483 - $1,280	452%
Three Rivers Provider Network- All Plans	$483 - $1,280	452%
Partnership Mcal - All Plans	$886 - $2,346	830%

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 $446.
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 Adventist Health Clearlake 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.