CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $916
  • Cash Discount Price: $1,239
  • vs. Medicare Baseline: 8.58x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at HSHS St Elizabeth's Hospital is $916. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,239. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.58x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$1,239

Average discount available for prompt cash payment at this facility.

Insurance Median
$916

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: $1,239 (1160%)
Insurance Median: $916 (858%)
Cash: $1,239 (1160% of Medicare)
Ins. Median: $916 (858% 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 858% of the Medicare baseline (a markup of 758%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $44 - $1,212 41%
Blue Cross Blue Shield $44 - $1,721 41%
Claim Doc $44 - $297 41%
Clear Spring Health Of Illinois $44 - $119 41%
Health Alliance Medical Plans $44 - $1,463 41%
Health Partners $44 - $119 41%
Hopetrust $44 - $285 41%
Humana $44 - $119 41%
Molina Healthcare $44 - $124 41%
Naphcare $44 - $257 41%
Sae Hospice $44 - $119 41%
UnitedHealthcare $44 - $1,721 41%
Meridian Health Plan $104 97%
Celtic Insurance Company $237 222%
Amish Community $482 451%
Cigna $916 - $1,721 858%
Wellfirst $1,108 1037%
First Health $1,280 1198%
Healthlink $1,368 - $1,721 1281%
Caterpillar, Inc. $1,382 1294%
Consociate Group $1,514 1417%
Choicecare $1,549 1450%
Healthcare Finest Network (Hfn) $1,549 1450%
Multiplan/Phcs $1,549 1450%
Provider Network Of America $1,549 1450%
City Of Springfield $1,721 1611%
Current Health Solutions $1,721 1611%
Healthscope $1,721 1611%
Illinois Breast And Cervical Cancer Program $1,721 1611%
Interplan $1,721 1611%
Live360 $1,721 1611%
Wexford $1,721 1611%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals