CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Boone County Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $393
Cash Discount Price: $699
vs. Medicare Baseline: 3.68x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Boone County Hospital is $393. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $699. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.68x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$699

Average discount available for prompt cash payment at this facility.

Insurance Median

$393

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: $699 (654%)

Insurance Median: $393 (368%)

Cash: $699 (654% of Medicare)

Ins. Median: $393 (368% 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 368% of the Medicare baseline (a markup of 268%). 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
Tricare	$107	100%
Wellmark Hmo	$187	175%
Wellmark Ppo - All Other Plans	$206	193%
Choice Care Mcr Adv - All Plans	$358	335%
Humana	$358 - $786	335%
Iowa Hlth Adv - All Plans	$358	335%
Mt Carmel Hp - All Plans	$358	335%
UnitedHealthcare	$358 - $513	335%
Va Ccn-All Plans	$358	335%
Amerigroup Mcr Adv - All Other Plans	$362	339%
Aetna	$366 - $681	343%
Meridian Mcaid - All Plans	$393	368%
Iowa Total Care Mcaid - All Plans	$401	375%
Medicaid / KanCare	$405	379%
Healthsmart Accell Network	$611	572%
Medical Associates Hp-All Plans	$655	613%
Healthsmart Ppo - All Other Plans	$699	654%
Health Alliance-All Plans	$786	736%
Midlands Choice-All Plans	$803	752%
Mutually Preferred-All Plans	$830	777%

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 $699.
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 Boone 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.