CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Pinckneyville Community Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $495
  • Cash Discount Price: $804
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Pinckneyville Community Hospital is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $804. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.63x the Medicare baseline. Located in 5383 State Route 154, Pinckneyville, IL.
Cash / Self-Pay
$804

Average discount available for prompt cash payment at this facility.

Insurance Median
$495

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: $804 (753%)
Insurance Median: $495 (463%)
Cash: $804 (753% of Medicare)
Ins. Median: $495 (463% 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 463% of the Medicare baseline (a markup of 363%). 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
Umwa Mcr Adv - All Plans $37 - $495 35%
UnitedHealthcare $37 - $1,097 35%
Wellcare Mcr Adv - All Plans $37 - $495 35%
Aetna $38 - $1,204 36%
Humana $38 - $495 36%
Cigna $45 - $1,104 42%
Ambetter / Centene $72 - $919 67%
Blue Cross Blue Shield $72 - $963 67%
Medicaid / KanCare $72 - $919 67%
Healthlink Hmo $167 - $1,050 156%
Healthlink Ppo - All Other Plans $167 - $1,104 156%
Phcs Savility $230 - $1,137 215%
Multiplan - All Plans $243 - $1,204 228%
Phcs - All Other Plans $243 - $1,097 228%
Healthlink Work Comp $1,104 1034%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5383 State Route 154, Pinckneyville, IL 62274
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals