CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $414
Cash Discount Price: $575
vs. Medicare Baseline: 3.88x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Munson Healthcare Otsego Memorial Hospital is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $575. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.88x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$575

Average discount available for prompt cash payment at this facility.

Insurance Median

$414

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: $575 (538%)

Insurance Median: $414 (388%)

Cash: $575 (538% of Medicare)

Ins. Median: $414 (388% 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 388% of the Medicare baseline (a markup of 288%). 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	$18 - $540	17%
Mclaren Health Plan	$18 - $724	17%
Meridian	$18 - $54	17%
Molina	$18 - $112	17%
Priority Health	$18 - $288	17%
UnitedHealthcare	$18 - $692	17%
Aetna	$27 - $700	25%
Blue Care Network	$27 - $104	25%
Hap (Health Alliance Plan)	$27 - $691	25%
Humana	$27 - $104	25%
Medicare (plans)	$27 - $104	25%
Michigan Amish Medical Board	$27 - $104	25%
Northern Michigan Mennonite Group	$27 - $104	25%
Asr Physicians Care Network	$40 - $691	37%
Cigna	$42 - $288	39%
Nomi Health	$43 - $691	40%
Employee Benefit Logistics	$46 - $177	43%
Hospice Of Michigan	$393 - $518	368%
Munson Hospice	$458 - $852	429%
Enterprise Group Planning/Employee Benefit Plan	$524 - $691	491%
Cofinity	$557 - $734	521%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$557 - $734	521%
Three Rivers Provider Network	$557 - $734	521%

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 $575.
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 Munson Healthcare Otsego Memorial 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.