CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Boston Children's Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $544
Cash Discount Price: $766
vs. Medicare Baseline: 5.09x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Boston Children's Hospital is $544. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $766. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.09x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$766

Average discount available for prompt cash payment at this facility.

Insurance Median

$544

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: $766 (717%)

Insurance Median: $544 (509%)

Cash: $766 (717% of Medicare)

Ins. Median: $544 (509% 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 509% of the Medicare baseline (a markup of 409%). 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	$232 - $506	217%
Unicare	$299	280%
Cdphp	$375 - $651	351%
Harvard Pilgrim	$389 - $518	364%
United	$458 - $640	429%
Aetna	$460 - $642	431%
Mgb/Allways	$466 - $566	436%
Tufts Public Plan	$471 - $472	441%
United Ri Nj Ny	$483	452%
Ambetter / Centene	$484	453%
Carelon Strategies/Bhs	$498	466%
UnitedHealthcare	$498 - $651	466%
Carelon/Beacon	$574	537%
Fallon	$584 - $591	547%
Health New England	$619	580%
Cigna	$651 - $691	609%
Ets/Lifetrac	$651	609%
Interlink Transplant	$651	609%
Community Health Options	$689	645%
Humana	$689	645%
Coventry/Hcvm/First Health	$705	660%
Multiplan/Phcs	$705 - $728	660%

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 $766.
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 Boston Children's Hospital 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.