CMS Price Transparency Data
Ultrasound, abdomen (limited)
Facility: Mercy Health Lakeshore Campus
Billing Code: 76705 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76705
- Insurance Median: $493
- Cash Discount Price: $358
- vs. Medicare Baseline: 4.62x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Mercy Health Lakeshore Campus is $493. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.62x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$358
Average discount available for prompt cash payment at this facility.
Insurance Median
$493
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: $358 (335%)
Insurance Median: $493 (462%)
Cash: $358 (335% of Medicare)
Ins. Median: $493 (462% 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 462% of the Medicare baseline (a markup of 362%). 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 | $79 - $135 | 74% |
| Medicaid / KanCare | $79 - $80 | 74% |
| Access Health | $96 | 90% |
| Blue Care Network Advantage | $135 | 126% |
| Medicare (plans) | $135 | 126% |
| Aetna | $138 | 129% |
| Align Senior Care | $138 | 129% |
| Correctional Recovery | $138 | 129% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $155 | 145% |
| Wellpath | $156 | 146% |
| Oscar | $169 | 158% |
| Vitalcore | $184 | 172% |
| U Of M Health Plan | $190 - $493 | 178% |
| UnitedHealthcare | $193 - $496 | 181% |
| Molina Marketplace | $229 | 214% |
| Hospice Of Michigan | $303 | 284% |
| Nomi Health | $309 | 289% |
| Hap | $413 - $506 | 387% |
| Wc Accident Fund | $435 | 407% |
| Wc Advantage | $435 | 407% |
| Wc Aig | $435 | 407% |
| Wc Allied | $435 | 407% |
| Wc Amerisure | $435 | 407% |
| Wc Amtrust | $435 | 407% |
| Wc Asu Risk Mgt | $435 | 407% |
| Wc Berkley Admin | $435 | 407% |
| Wc Broadspire | $435 | 407% |
| Wc Bunch & Associates | $435 | 407% |
| Wc Ccmsi | $435 | 407% |
| Wc Emc Insurance Company | $435 | 407% |
| Wc Esis | $435 | 407% |
| Wc Fcci | $435 | 407% |
| Wc Federated | $435 | 407% |
| Wc Gallagher Bassett | $435 | 407% |
| Wc Genex Care For Ohio | $435 | 407% |
| Wc Guard Insurance Company | $435 | 407% |
| Wc Hartford | $435 | 407% |
| Wc Liberty Mutual | $435 | 407% |
| Wc Meijers | $435 | 407% |
| Wc Michigan | $435 | 407% |
| Wc Mitchell Frankenmuth | $435 | 407% |
| Wc Pma | $435 | 407% |
| Wc Sedgwick | $435 | 407% |
| Wc Sentry | $435 | 407% |
| Wc Travelers | $435 | 407% |
| Wc Tristar | $435 | 407% |
| Wc Walmart | $435 | 407% |
| Wc Zurich | $435 | 407% |
| Asr Health Benefits | $459 | 430% |
| 1199 National Benefit Fund | $474 | 444% |
| Allied National Global Care | $474 | 444% |
| Asrm - Reliance Standard Life Insurance | $474 | 444% |
| Christian Care Ministry | $474 | 444% |
| Dean Health | $474 | 444% |
| Fallon Health | $474 | 444% |
| Family Life Insurance Company | $474 | 444% |
| Ghc Scw | $474 | 444% |
| Group Pension Administrators | $474 | 444% |
| International Benefit Administrators | $474 | 444% |
| Lifetime Benefit Solutions | $474 | 444% |
| Manhattan Life | $474 | 444% |
| Medi Share | $474 | 444% |
| Multiplan | $474 | 444% |
| Mvp | $474 | 444% |
| Pai | $474 | 444% |
| Pan-American Life | $474 | 444% |
| Paramount Hmo | $474 | 444% |
| Phcs | $474 | 444% |
| Trinity Health Share | $474 | 444% |
| Cigna | $478 | 448% |
| Caresource | $492 | 461% |
| Acclaim | $493 | 462% |
| Administrative Concepts | $493 | 462% |
| Allegeant | $493 | 462% |
| Allied Benefit Systems | $493 | 462% |
| Ameriben | $493 | 462% |
| American Family | $493 | 462% |
| American Healthcare Alliance | $493 | 462% |
| American Republic | $493 | 462% |
| Amerihealth | $493 | 462% |
| Aultcare | $493 | 462% |
| Automated Benefit Services | $493 | 462% |
| Auxiant | $493 | 462% |
| Benefit Administrative Systems,Llc | $493 | 462% |
| Boon Chapman | $493 | 462% |
| Cam Administrative Services | $493 | 462% |
| Christian Brother Services | $493 | 462% |
| Christian Brothers Holy Cross | $493 | 462% |
| Claimchoice Adminstrators | $493 | 462% |
| Comprehensive Benefits | $493 | 462% |
| Consociate | $493 | 462% |
| Continental Life Insurance | $493 | 462% |
| Custom Benefit Administrators | $493 | 462% |
| Cypress Benefit Administrators | $493 | 462% |
| Employee Benefit Concepts | $493 | 462% |
| Employee Benefit Management | $493 | 462% |
| Enterprise Group Planning | $493 | 462% |
| Forest County Potawatomi | $493 | 462% |
| Freedom Life Insurance Company | $493 | 462% |
| Group Administrators | $493 | 462% |
| Group Marketing Services | $493 | 462% |
| Guardian | $493 | 462% |
| Health America | $493 | 462% |
| Health Choices | $493 | 462% |
| Health Smart | $493 | 462% |
| Healthez | $493 | 462% |
| Healthgram | $493 | 462% |
| Healthscope | $493 | 462% |
| Humana | $493 | 462% |
| Insight | $493 | 462% |
| Intercare | $493 | 462% |
| Jfp Benefit Management | $493 | 462% |
| Jp Farley Corporation | $493 | 462% |
| Key Benefit Administrator | $493 | 462% |
| Liberty Union Life Assurance Co | $493 | 462% |
| Lucent Health | $493 | 462% |
| Luminare Health | $493 | 462% |
| Luminare Health (Detroit) | $493 | 462% |
| Medben | $493 | 462% |
| Medcost | $493 | 462% |
| Medical Mutual | $493 | 462% |
| Mutual Health Services | $493 | 462% |
| Mutual Of Omaha | $493 | 462% |
| Ncas | $493 | 462% |
| Nippon Life Ins | $493 | 462% |
| Nova | $493 | 462% |
| Painters Union Insurance Fund | $493 | 462% |
| Physicians Mutual | $493 | 462% |
| Plumbers Local 98 Insurance Fund | $493 | 462% |
| Prairie States | $493 | 462% |
| Primary Physician Care | $493 | 462% |
| Professional Benefit Administrators | $493 | 462% |
| Secureone Preferred United Plans | $493 | 462% |
| The Loomis Company | $493 | 462% |
| Trustmark Small Business Benefits | $493 | 462% |
| Unicare | $493 | 462% |
| Unified Group Services | $493 | 462% |
| Us Health And Life | $493 | 462% |
| Valenz | $493 | 462% |
| Varipro | $493 - $506 | 462% |
| Western & Southern Financial Group | $493 | 462% |
| Wps | $493 | 462% |
| Geha | $496 | 464% |
| Priority Health | $497 | 465% |
| First Health | $498 | 466% |