CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Calais Community Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $576
  • Cash Discount Price: $544
  • vs. Medicare Baseline: 5.39x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Calais Community Hospital is $576. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $544. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.39x the Medicare baseline. Located in 24 Hospital Lane, Calais, ME.
Cash / Self-Pay
$544

Average discount available for prompt cash payment at this facility.

Insurance Median
$576

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: $544 (509%)
Insurance Median: $576 (539%)
Cash: $544 (509% of Medicare)
Ins. Median: $576 (539% 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 539% of the Medicare baseline (a markup of 439%). 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
Blue Cross Blue Shield $150 - $576 140%
UnitedHealthcare $150 - $624 140%
Humana $319 299%
Wellcare $319 299%
Partners Direct Health $420 393%
Cigna $610 571%
Aetna $624 584%
Martins Point $653 611%
Harvard Pilgrim $663 621%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24 Hospital Lane, Calais, ME 04619
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals