CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Adventist Health Clearlake

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $462
Cash Discount Price: $385
vs. Medicare Baseline: 4.33x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Adventist Health Clearlake is $462. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.33x the Medicare baseline. Located in 15630 18Th Ave - Hwy 53, Clearlake, CA.

Cash / Self-Pay

$385

Average discount available for prompt cash payment at this facility.

Insurance Median

$462

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: $385 (360%)

Insurance Median: $462 (433%)

Cash: $385 (360% of Medicare)

Ins. Median: $462 (433% 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 433% of the Medicare baseline (a markup of 333%). 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
Bc Managed Mcal	$87	81%
Medi-Cal	$87	81%
Blue Shield Mcr Adv	$102 - $257	95%
Kaiser Mcr Adv	$102 - $257	95%
Tricare	$102 - $257	95%
Blue Cross Blue Shield	$106 - $476	99%
UnitedHealthcare	$112 - $1,022	105%
Ah Employee Health Plan - All Plans	$204 - $515	191%
Aetna	$363 - $916	340%
Western Growers- All Plans	$364 - $920	341%
Blue Shield Epn - All Other Plans	$373 - $942	349%
Blue Shield Non-Epn	$373 - $942	349%
First Health- All Plans	$389 - $981	364%
Healthnet- All Plans	$399 - $1,005	374%
Foundation- All Plans	$413 - $1,042	387%
Health Mgmt Network- All Plans	$413 - $1,042	387%
Humana	$413 - $1,042	387%
Phcs- All Plans	$413 - $1,042	387%
Cigna	$437 - $1,103	409%
Interplan- All Plans	$437 - $1,103	409%
Kaiser- All Other Plans	$437 - $1,103	409%
Three Rivers Provider Network- All Plans	$437 - $1,103	409%
Partnership Mcal - All Plans	$802 - $2,023	751%

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 $385.
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 Adventist Health Clearlake 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.