CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Memorial Hospital and Health Care Center

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $78
Cash Discount Price: $128
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Memorial Hospital and Health Care Center is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $128. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.73x the Medicare baseline. Located in 800 W 9Th St, Jasper, IN.

Cash / Self-Pay

$128

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $128 (120%)

Insurance Median: $78 (73%)

Cash: $128 (120% of Medicare)

Ins. Median: $78 (73% 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.

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
Blue Cross Blue Shield	$22 - $111	21%
Aetna	$26 - $141	24%
Caresource In Marketplace	$26 - $139	24%
Chamber Care	$26	24%
Humana	$26 - $111	24%
Mdwise	$26 - $80	24%
Mhs Hoosier Care Connect	$26 - $80	24%
Tricare	$26 - $95	24%
UnitedHealthcare	$30 - $334	28%
Immergrun	$31 - $94	29%
Ambetter / Centene	$34 - $145	32%
Onecare	$34 - $102	32%
Siho	$34 - $102	32%
Encore	$41 - $114	38%
Encore Elite +	$41 - $267	38%
Noncontracted	$41 - $178	38%
Patoka Valley	$45 - $137	42%
Cigna	$46 - $141	43%
Sagamore	$46 - $141	43%

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 $128.
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 Memorial Hospital and Health Care Center 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.