CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: St Joseph Health System, LLC

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $495
  • Cash Discount Price: $481
  • vs. Medicare Baseline: 4.63x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at St Joseph Health System, LLC is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $481. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.63x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$481

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: $481 (450%)
Insurance Median: $495 (463%)
Cash: $481 (450% 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
Amish Aid $18 - $504 17%
Self Pay $18 - $1,156 17%
Php $19 - $840 18%
Lutheran Preferred $22 - $1,261 21%
Php Freedom Network $24 - $250 22%
Cigna $25 - $2,102 23%
Blue Cross Blue Shield $28 - $762 26%
Aetna $35 - $1,429 33%
Encore Ppo $39 - $1,892 37%
Sagamore $40 - $1,137 37%
Lutheran Network $42 - $1,156 39%
Multiplan $53 - $1,640 50%
First Health $58 - $1,576 54%
Prime Health Services $58 - $1,576 54%
Align Network $62 - $1,682 58%
Frontpath Health Coalition $62 - $1,682 58%
Advantage Health Solutions $64 - $1,745 60%
Allied Benefit Systems $69 - $1,892 65%
Spreemo $72 67%
Medical Mutual Of Ohio $77 - $2,102 72%
Parkview Healthplan Services $77 - $2,102 72%
Value Options $77 - $2,102 72%
Veterans Eval Services $77 - $98 72%
UnitedHealthcare $98 - $1,047 92%
Tricare $105 98%
Humana $109 - $216 102%
Managed Health Services $109 - $221 102%
Medicare (plans) $109 102%
Department Of Veterans Affairs $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
In Dept Of Correction $115 108%
Node Pphp Mcr Adv $116 109%
Us Department Of Labor $138 129%
Lutheran Advanced Network $166 155%
Encore Work Comp In $199 186%
Caresource $216 202%
Medicaid / KanCare $216 202%
Work Comp $221 207%
Encore Kba Epo $265 248%
Encore Kba Ppo $332 311%
Three Rivers $495 463%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals