CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Virginia Gay Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $476
Cash Discount Price: $797
vs. Medicare Baseline: 4.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Virginia Gay Hospital is $476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $797. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.46x the Medicare baseline. Located in 502 North 9Th Avenue, Vinton, IA.

Cash / Self-Pay

$797

Average discount available for prompt cash payment at this facility.

Insurance Median

$476

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: $797 (746%)

Insurance Median: $476 (446%)

Cash: $797 (746% of Medicare)

Ins. Median: $476 (446% 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 446% of the Medicare baseline (a markup of 346%). 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
Medicaid / KanCare	$107 - $428	100%
Aetna	$118	110%
Wellmark Hmo	$303	284%
Wellmark Ppo-All Other Plans	$333	312%
UnitedHealthcare	$337 - $476	316%
Va Ccn-All Plans	$367 - $370	344%
Health Alliance Mcr Adv	$387 - $390	362%
Medical Associates-All Plans	$744 - $750	697%
Cedar Valley Community Healthcare-All Plans	$781 - $787	731%
Humana	$793 - $800	742%
Health Partners-All Plans	$843 - $850	789%
Healthsmart-All Plans	$843 - $850	789%
Corvel-All Plans	$922 - $930	863%
Health Alliance-All Other Plans	$942 - $950	882%

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 $797.
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 Virginia Gay Hospital 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.