CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Monroe County Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $609
Cash Discount Price: $732
vs. Medicare Baseline: 5.70x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Monroe County Hospital is $609. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $732. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.70x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$732

Average discount available for prompt cash payment at this facility.

Insurance Median

$609

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: $732 (685%)

Insurance Median: $609 (570%)

Cash: $732 (685% of Medicare)

Ins. Median: $609 (570% 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 570% of the Medicare baseline (a markup of 470%). 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
Wellmark Hmo	$140	131%
Wellmark Ppo - All Other Plans	$150	140%
Mahp Mcare - All Plans	$482 - $566	451%
Tricare	$482 - $566	451%
UnitedHealthcare	$482 - $1,281	451%
Va Ccn - All Plans	$482 - $566	451%
Amerigroup Mcare	$487 - $572	456%
Humana	$487 - $572	456%
Wellmark Mcare	$487 - $572	456%
Aetna	$492 - $1,267	461%
Iowa Total Care Mcaid - All Plans	$574 - $674	537%
Molina Mcaid - All Plans	$582 - $684	545%
Amerigroup Mcaid - All Other Plans	$591 - $694	553%
Centivo - All Plans	$723 - $849	677%
Midlands Choice - All Plans	$804 - $944	753%
Preferred Hlth - All Plans	$861 - $1,011	806%
Geha - All Plans	$918 - $1,078	859%
Multiplan - All Plans	$1,033 - $1,213	967%
Integrated Hp - All Plans	$1,114 - $1,308	1043%

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 $732.
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 Monroe County 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.