CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Palos Community Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $1,719
Cash Discount Price: $1,604
vs. Medicare Baseline: 16.09x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Palos Community Hospital is $1,719. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,604. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.09x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$1,604

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,719

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: $1,604 (1502%)

Insurance Median: $1,719 (1609%)

Cash: $1,604 (1502% of Medicare)

Ins. Median: $1,719 (1609% 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 1609% of the Medicare baseline (a markup of 1509%). 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
Blue Cross Blue Shield	$367 - $2,292	344%
Aetna	$493 - $2,292	462%
Carelon Behavioral Health [159]	$1,146	1073%
Healthlink [125]	$1,146 - $2,292	1073%
First Health Plan [6034]	$1,302 - $1,719	1219%
Magellan Behavioral Hlth [136]	$1,375	1287%
The Alliance [1703]	$1,472	1378%
Multiplan/Phcs [142]	$1,604 - $2,292	1502%
Compsych [112]	$1,719	1609%
Beechstreet [176]	$1,834	1717%
Cigna	$1,834 - $2,292	1717%
Health'S Finest Network [126]	$1,948	1824%
Galaxy Health Network [220]	$2,292	2146%
Global Excel [1712]	$2,292	2146%
Health Alliance [181]	$2,292	2146%
UnitedHealthcare	$2,292	2146%

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 $1,604.
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 Palos Community 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.