CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $391
  • Cash Discount Price: $745
  • vs. Medicare Baseline: 3.66x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Saint Joseph Regional Medical Center - Plymouth is $391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $745. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.66x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$745

Average discount available for prompt cash payment at this facility.

Insurance Median
$391

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: $745 (698%)
Insurance Median: $391 (366%)
Cash: $745 (698% of Medicare)
Ins. Median: $391 (366% 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 366% of the Medicare baseline (a markup of 266%). 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 $57 - $745 53%
Blue Cross Blue Shield $57 - $391 53%
Medicaid / KanCare $57 - $380 53%
UnitedHealthcare $57 - $730 53%
Medicare (plans) $111 - $113 104%
Meridian Complete $111 104%
Pace-Trinity Health $111 104%
County Coroner $115 108%
Provider Partners Health Plan Of Indiana $122 114%
Auxiant $166 - $951 155%
Physicians Health Plan Northern Indiana Health Insurance $166 - $334 155%
St Joseph County Hlth Dpt $166 155%
Caresource $171 160%
Siho Insurance Services $177 166%
Key Benefit Administrator $199 - $804 186%
Allied Benefit Systems $210 - $745 197%
Managed Health Services - Indiana $216 - $380 202%
Mdwise $216 - $380 202%
Custom Design Benefits $238 223%
Plain Church Group $309 289%
Blue Benefit Administrators Of Massachusetts $391 366%
Blue Care Network $391 366%
Blue Distinction Transplant $391 366%
Blue Shield - Ca $391 366%
Blue Shield - Id (Regence) $391 366%
Blue Shield - Ny Highmark Northeastern $391 366%
Blue Shield - Ny Highmark Western $391 366%
Blue Shield - Pa (Highmark) $391 366%
Blue Shield - Wa (Regence) $391 366%
Notre Dame Athletic Association $630 590%
Wc Notre Dame $630 590%
Luminare Health (Detroit) $653 - $688 611%
Ameriben $688 644%
Geha $730 683%
Healthscope $730 683%
Student Insurance Cma $730 683%
Asr Health Benefits $745 698%
Christian Brother Services $745 698%
Employee Benefit Management $745 698%
Medical Mutual $745 698%
Meritain $745 698%
Preferred One $745 698%
Rural Carrier Health Benefit Plan $745 698%
Webtpa $745 698%
Encore Health $804 753%
Indiana Criminal Justice Inst $804 753%
Western & Southern Financial Group $804 753%
Cigna $825 772%
Group Administrators $825 772%
Health Partners $825 772%
Mvp $825 772%
Prairie States $825 772%
Priority Health $825 772%
Professional Benefit Administrators $825 772%
Sagamore Health Network $825 - $882 772%
Sisco Benefits $825 772%
Unified Group Services $825 772%
Goshen Preferred Network $882 - $986 826%
Signature Care $951 890%
Allied National Global Care $1,031 965%
Asrm - Reliance Standard Life Insurance $1,031 965%
Avmed Health Plan $1,031 965%
Christian Care Ministry $1,031 965%
Dean Health $1,031 965%
Fallon Health $1,031 965%
Family Life Insurance Company $1,031 965%
Freedom Life Insurance Company $1,031 965%
Ghc Scw $1,031 965%
International Benefit Administrators $1,031 965%
Lifetime Benefit Solutions $1,031 965%
Manhattan Life $1,031 965%
Medi Share $1,031 965%
Multiplan $1,031 965%
Pai $1,031 965%
Pan-American Life $1,031 965%
Paramount Hmo $1,031 965%
Phcs $1,031 965%
Philadelphia American Life Insurance $1,031 965%
Trinity Health Share $1,031 965%
Bankers Life Casualty $1,146 1073%
Bureau Of Disability $1,146 1073%
Wc Align Network $1,146 1073%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals