CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Pali Momi Medical Center

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $151
Cash Discount Price: $330
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Pali Momi Medical Center is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $330. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$330

Average discount available for prompt cash payment at this facility.

Insurance Median

$151

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: $330 (309%)

Insurance Median: $151 (141%)

Cash: $330 (309% of Medicare)

Ins. Median: $151 (141% 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.

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
UnitedHealthcare	$47	44%
Hmsa	$51 - $126	48%
Alohacare	$59 - $139	55%
Ohana	$61 - $151	57%
Mdx	$89 - $126	83%
Devoted	$132	124%
Pac Admin	$136	127%
Uha	$151	141%
Hwmg/Hmaa	$153	143%
Verdegard	$260	243%
Calvos	$309 - $516	289%
Mimoh	$309 - $516	289%
Hcha	$330 - $550	309%
Kaiser	$330 - $550	309%
Multiplan	$330 - $585	309%
Coventry	$350 - $585	328%
Mccp	$350 - $585	328%

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 $330.
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 Pali Momi Medical Center 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.