CMS Price Transparency Data
Ultrasound, abdomen (limited)
Facility: Trinity Health Oakland Hospital
Billing Code: 76705 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76705
- Insurance Median: $651
- Cash Discount Price: $623
- vs. Medicare Baseline: 6.09x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Trinity Health Oakland Hospital is $651. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $623. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.09x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$623
Average discount available for prompt cash payment at this facility.
Insurance Median
$651
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: $623 (583%)
Insurance Median: $651 (609%)
Cash: $623 (583% of Medicare)
Ins. Median: $651 (609% 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 609% of the Medicare baseline (a markup of 509%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $57 - $58 | 53% |
| Blue Cross Blue Shield | $58 - $102 | 54% |
| Aetna | $67 - $434 | 63% |
| Geha | $67 - $718 | 63% |
| Medical Mutual | $67 | 63% |
| Meritain | $67 | 63% |
| Bcn Domestic | $94 | 88% |
| Blue Benefit Administrators Of Massachusetts | $94 | 88% |
| Blue Care Network | $94 | 88% |
| Blue Distinction Transplant | $94 | 88% |
| Blue Shield - Ca | $94 | 88% |
| Blue Shield - Id (Regence) | $94 | 88% |
| Blue Shield - Ny Highmark Northeastern | $94 | 88% |
| Blue Shield - Ny Highmark Western | $94 | 88% |
| Blue Shield - Pa (Highmark) | $94 | 88% |
| Blue Shield - Wa (Regence) | $94 | 88% |
| Health Choices | $94 - $703 | 88% |
| Kaiser Domestic | $94 | 88% |
| Blue Care Network Advantage | $102 | 95% |
| Medicare (plans) | $102 - $104 | 95% |
| Align Senior Care | $104 | 97% |
| Hospice Advantage | $104 | 97% |
| UnitedHealthcare | $107 - $718 | 100% |
| Cca - Zing Health | $110 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $117 | 110% |
| Molina Marketplace | $135 | 126% |
| Priority Health | $149 - $165 | 140% |
| Asr Health Benefits | $158 | 148% |
| Caresource | $158 | 148% |
| Hap | $158 - $698 | 148% |
| Varipro | $158 | 148% |
| Health Cost Solutions | $161 | 151% |
| Vitalcore | $161 | 151% |
| Wellpath | $161 | 151% |
| U Of M Health Plan | $190 | 178% |
| Employee Benefit Logistic | $240 | 225% |
| Wc Accident Fund | $291 | 272% |
| Wc Advantage | $291 | 272% |
| Wc Aig | $291 | 272% |
| Wc Allied | $291 | 272% |
| Wc Amerisure | $291 | 272% |
| Wc Amtrust | $291 | 272% |
| Wc Asu Risk Mgt | $291 | 272% |
| Wc Berkley Admin | $291 | 272% |
| Wc Broadspire | $291 | 272% |
| Wc Bunch & Associates | $291 | 272% |
| Wc Ccmsi | $291 | 272% |
| Wc Emc Insurance Company | $291 | 272% |
| Wc Esis | $291 | 272% |
| Wc Fcci | $291 | 272% |
| Wc Federated | $291 | 272% |
| Wc Gallagher Bassett | $291 | 272% |
| Wc Genex Care For Ohio | $291 | 272% |
| Wc Guard Insurance Company | $291 | 272% |
| Wc Hartford | $291 | 272% |
| Wc Liberty Mutual | $291 | 272% |
| Wc Meijers | $291 | 272% |
| Wc Michigan | $291 | 272% |
| Wc Mitchell Frankenmuth | $291 | 272% |
| Wc Pma | $291 | 272% |
| Wc Sedgwick | $291 | 272% |
| Wc Sentry | $291 | 272% |
| Wc Travelers | $291 | 272% |
| Wc Tristar | $291 | 272% |
| Wc Walmart | $291 | 272% |
| Wc Zurich | $291 | 272% |
| Acs Benefit Services | $422 | 395% |
| Allied Benefit Systems | $422 | 395% |
| Claimchoice Adminstrators | $422 | 395% |
| Consociate | $422 | 395% |
| Cypress Benefit Administrators | $422 | 395% |
| Forest County Potawatomi | $422 | 395% |
| Health Smart | $422 | 395% |
| Healthgram | $422 | 395% |
| Healthscope | $422 | 395% |
| Secureone Preferred United Plans | $422 | 395% |
| Sisco Benefits | $422 | 395% |
| The Health Plan | $422 | 395% |
| Trustmark Small Business Benefits | $422 | 395% |
| Unified Group Services | $422 | 395% |
| Webtpa | $422 | 395% |
| Mclaren Health | $461 - $502 | 432% |
| Carelon Behavioral Health | $479 | 448% |
| Magellan Behavioral Health | $575 | 538% |
| 1199 National Benefit Fund | $651 | 609% |
| Allied National Global Care | $651 | 609% |
| Asrm - Reliance Standard Life Insurance | $651 | 609% |
| Christian Care Ministry | $651 | 609% |
| Dean Health | $651 | 609% |
| Fallon Health | $651 | 609% |
| Family Life Insurance Company | $651 | 609% |
| Ghc Scw | $651 | 609% |
| Group Pension Administrators | $651 | 609% |
| International Benefit Administrators | $651 | 609% |
| Lifetime Benefit Solutions | $651 | 609% |
| Manhattan Life | $651 | 609% |
| Medi Share | $651 | 609% |
| Multiplan | $651 | 609% |
| Mvp | $651 | 609% |
| Pai | $651 | 609% |
| Pan-American Life | $651 | 609% |
| Paramount Hmo | $651 | 609% |
| Phcs | $651 | 609% |
| Trinity Health Share | $651 | 609% |
| Health Partners | $698 | 653% |
| Tufts Health Plan | $698 | 653% |
| Access Health | $703 | 658% |
| Acclaim | $703 | 658% |
| Administrative Concepts | $703 | 658% |
| Allegeant | $703 | 658% |
| Ameriben | $703 | 658% |
| American Family | $703 | 658% |
| American Healthcare Alliance | $703 | 658% |
| American National | $703 | 658% |
| American Republic | $703 | 658% |
| Amerihealth | $703 | 658% |
| Aultcare | $703 | 658% |
| Automated Benefit Services | $703 | 658% |
| Auxiant | $703 | 658% |
| Benefit Administrative Systems,Llc | $703 | 658% |
| Boon Chapman | $703 | 658% |
| Cam Administrative Services | $703 | 658% |
| Christian Brother Services | $703 | 658% |
| Christian Brothers Holy Cross | $703 | 658% |
| Comprehensive Benefits | $703 | 658% |
| Continental Life Insurance | $703 | 658% |
| Custom Benefit Administrators | $703 | 658% |
| Employee Benefit Concepts | $703 | 658% |
| Employee Benefit Management | $703 | 658% |
| Enterprise Group Planning | $703 | 658% |
| Freedom Life Insurance Company | $703 | 658% |
| Group Administrators | $703 | 658% |
| Group Marketing Services | $703 | 658% |
| Guardian | $703 | 658% |
| Health America | $703 | 658% |
| Healthcare Management Admin | $703 | 658% |
| Healthez | $703 | 658% |
| Humana | $703 | 658% |
| Insight | $703 | 658% |
| Intercare | $703 | 658% |
| Jfp Benefit Management | $703 | 658% |
| Jp Farley Corporation | $703 | 658% |
| Key Benefit Administrator | $703 | 658% |
| Liberty Union Life Assurance Co | $703 | 658% |
| Lucent Health | $703 | 658% |
| Luminare Health | $703 | 658% |
| Luminare Health (Detroit) | $703 | 658% |
| Magnacare | $703 | 658% |
| Medben | $703 | 658% |
| Medcost | $703 | 658% |
| Mutual Health Services | $703 | 658% |
| Mutual Of Omaha | $703 | 658% |
| Ncas | $703 | 658% |
| Nippon Life Ins | $703 | 658% |
| Nova | $703 | 658% |
| Painters Union Insurance Fund | $703 | 658% |
| Physicians Mutual | $703 | 658% |
| Plumbers Local 98 Insurance Fund | $703 | 658% |
| Prairie States | $703 | 658% |
| Preferred One | $703 | 658% |
| Primary Physician Care | $703 | 658% |
| Professional Benefit Administrators | $703 | 658% |
| Siho Insurance Services | $703 | 658% |
| The Loomis Company | $703 | 658% |
| Unicare | $703 | 658% |
| Us Health And Life | $703 | 658% |
| Valenz | $703 | 658% |
| Western & Southern Financial Group | $703 | 658% |
| Wps | $703 | 658% |
| Cigna | $710 | 665% |
| Coventry | $722 | 676% |
| First Health | $722 | 676% |
| Prime Health Services | $766 | 717% |
| Three Rivers Provider Network | $862 | 807% |
| Cmh Detroit Wayne Integrated Health Network | $958 | 897% |
| Cmh Lenawee County | $958 | 897% |
| Cmh Livingston County | $958 | 897% |
| Cmh Misc | $958 | 897% |
| Cmh Monroe County | $958 | 897% |
| Cmh Oakland County | $958 | 897% |
| Cmh Washtenaw County | $958 | 897% |