CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Golden Valley Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $107
  • Cash Discount Price: $576
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Golden Valley Memorial Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $576. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 1600 N 2Nd St, Clinton, MO.
Cash / Self-Pay
$576

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $576 (539%)
Insurance Median: $107 (100%)
Cash: $576 (539% of Medicare)
Ins. Median: $107 (100% 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.

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
Home State Health $98 92%
UnitedHealthcare $98 - $182 92%
Aetna $107 100%
Humana $107 100%
Ambetter / Centene $128 120%

Consumer Guidance & Cost Commentary

Golden Valley Memorial Hospital in Clinton, Missouri, offers an Ultrasound, abdomen (limited) procedure with a cash median rate of $576. This cash price is notably lower than the facility's gross charge of $960, which represents the maximum list price before any discounts. Patients should be aware that while the facility is a government-owned acute care hospital with a rating of 3, the cash rate may still be higher than the state or county average depending on the specific location's pricing benchmarks. It is important to verify with the hospital regarding "self-pay" or "prompt-pay" discounts, as paying upfront can sometimes result in significant fee reductions that bypass the administrative costs associated with insurance billing.

For patients with insurance, the negotiated rates vary by carrier, ranging from a low of $98 to a high of $182 depending on the specific plan. UnitedHealthcare plans show a range of $98 to $182, while Home State Health, Aetna, Humana, and Ambetter / Centene all have fixed negotiated rates of $98, $107, $107, and $128 respectively. Since the Medicare amount for this procedure is $106.81, commercial negotiated rates generally align closely with or slightly exceed the federal benchmark, though some plans like UnitedHealthcare can reach up to 182% of the Medicare rate. Consumers should check their deductible status before scheduling, as high negotiated rates may be fully applied if the deductible has not yet been met, potentially resulting in out-of-pocket costs that exceed the cash-pay option.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 N 2Nd St, Clinton, MO 64735
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals