CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Lmh

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $105
  • Cash Discount Price: $412
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Lmh is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $412. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 325 Maine Street, Lawrence, KS.
Cash / Self-Pay
$412

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $412 (386%)
Insurance Median: $105 (98%)
Cash: $412 (386% of Medicare)
Ins. Median: $105 (98% 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.

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
Medicare (plans) $39 - $105 37%
Humana $39 - $105 37%
UnitedHealthcare $39 - $1,093 37%
Cigna $39 - $1,100 37%
Haskell Indian Health Services $46 - $105 43%
Blue Cross Blue Shield $46 - $1,065 43%
Ambetter / Centene $47 - $163 44%
Allwell $47 - $107 44%
Aetna $1,049 - $1,367 982%
Non Contracted $1,317 1233%
First Health $1,531 1433%

Consumer Guidance & Cost Commentary

Lmh, an Acute Care Hospital located at 325 Maine Street in Lawrence, Kansas, performed an Ultrasound, abdomen (complete) with a cash median price of $412. For patients with commercial insurance, the negotiated rates vary significantly by plan, ranging from a low of $39 to a high of $1631 depending on the specific carrier, such as UnitedHealthcare or First Health. It is important to note that the facility's cash rate of $412 is substantially lower than the highest negotiated rates found for this procedure, which can benefit patients with high-deductible plans who may not yet have met their out-of-pocket maximum. While the data does not provide a specific county or state average for comparison, the wide variance in payer rates highlights the importance of verifying your specific plan's allowed amount before scheduling.

The Medicare benchmark for this service is $106.81, which serves as a cost-basis standard to evaluate the facility's pricing markup. Although the facility's cash rate of $412 is higher than the Medicare amount, it remains lower than several commercial negotiated rates, including those from Aetna and First Health. Patients should be aware that prompt-pay discounts, which typically range from 20% to 50%, may further reduce the final cash cost if paid upfront. To avoid unexpected charges, individuals should request a self-pay or prompt-pay discount prior to check-in and ensure they sign a waiver of insurance submission if they intend to pay in full without using their coverage.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 325 Maine Street, Lawrence, KS 66044
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals