CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Woodlawn Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $302
Cash Discount Price: $1,001
vs. Medicare Baseline: 2.83x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Woodlawn Hospital is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,001. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.83x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$1,001

Average discount available for prompt cash payment at this facility.

Insurance Median

$302

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: $1,001 (937%)

Insurance Median: $302 (283%)

Cash: $1,001 (937% of Medicare)

Ins. Median: $302 (283% 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 283% of the Medicare baseline (a markup of 183%). 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
Blue Cross Blue Shield	$70 - $1,069	66%
Caresource Mcaid Hww	$70	66%
Mdwise Excel Hhw & Hcc	$70	66%
Mhs Mcaid Hcc	$70	66%
Mhs Mcaid Hhw	$70	66%
UnitedHealthcare	$70 - $1,014	66%
Aetna	$293 - $1,267	274%
Caresource Mcaid Hip	$293	274%
Caresource Mcr Adv	$293	274%
Humana	$293 - $1,035	274%
Mdwise Mcaid Excel Hip	$293	274%
Mhs Exch Mrktplce-All Other Plans	$293	274%
Mhs Mcaid Hip	$293	274%
Mhs Mcr Adv	$299	280%
Caresource Exch - All Other Plans	$382	358%
Ambetter / Centene	$390	365%
Partners Direct Health-All Plans	$907	849%
Cigna	$955 - $1,134	894%
Parkview Health Plans-All Plans	$1,000	936%
Sagamore All Other Grps - All Other Plans	$1,121	1050%
Encore Comm-All Plans	$1,134	1062%
Phcs/Multiplan-All Plans	$1,241	1162%
Community Health Alliance-All Plans	$1,267	1186%

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 $1,001.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Woodlawn Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76700.
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.