CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Fayette County Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $215
Cash Discount Price: $825
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Fayette County Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $825. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.01x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$825

Average discount available for prompt cash payment at this facility.

Insurance Median

$215

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: $825 (772%)

Insurance Median: $215 (201%)

Cash: $825 (772% of Medicare)

Ins. Median: $215 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Aetna	$25 - $1,027	23%
Health Alliance Mcare	$27 - $476	25%
Healthlink Mcr Adv	$27 - $476	25%
Cigna	$32 - $1,117	30%
Coventry/Ghp-All Plans	$37 - $968	35%
Multiplan - All Plans	$51 - $1,266	48%
Health Alliance - All Other Plans	$55 - $1,230	51%
Blue Cross Blue Shield	$66 - $1,251	62%
UnitedHealthcare	$133 - $1,236	125%
Healthlink Hmo	$138 - $1,042	129%
Healthlink Ppo - All Other Plans	$138 - $1,191	129%
Illinicare - All Plans	$168 - $215	157%
Medicaid / KanCare	$168 - $215	157%
Meridian-All Plans	$168 - $215	157%
Humana	$476	446%

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 $825.
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 Fayette 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.