CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $655
Cash Discount Price: $2,046
vs. Medicare Baseline: 6.13x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Central Florida Lake Monroe Hospital is $655. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,046. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.13x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.

Cash / Self-Pay

$2,046

Average discount available for prompt cash payment at this facility.

Insurance Median

$655

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: $2,046 (1916%)

Insurance Median: $655 (613%)

Cash: $2,046 (1916% of Medicare)

Ins. Median: $655 (613% 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 613% of the Medicare baseline (a markup of 513%). 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
Freedom Health	$147	138%
Optimum	$147	138%
United	$245 - $920	229%
Simply	$315	295%
Molina Healthcare	$389 - $655	364%
Humana	$409	383%
Avmed	$491 - $1,023	460%
Sunshine State Health Plan	$522	489%
Corvel Corporation	$563	527%
Prime Health	$574	537%
Careworks (Rockport Community)	$592	554%
Aetna	$614	575%
Plotkin Health	$1,023	958%
Prime Health Sheriff	$1,023	958%
Multiplan	$1,534 - $1,739	1436%
Three Rivers Provider Network	$1,534	1436%
Ppo Next	$1,739	1628%
Novanet	$1,841	1724%

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 $2,046.
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 Central Florida Lake Monroe 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.