CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Atrium Health Cleveland

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $158
Cash Discount Price: $473
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Atrium Health Cleveland is $158. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $473. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.48x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$473

Average discount available for prompt cash payment at this facility.

Insurance Median

$158

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: $473 (443%)

Insurance Median: $158 (148%)

Cash: $473 (443% of Medicare)

Ins. Median: $158 (148% 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.

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
Alliance	$25 - $158	23%
Amerihealth Caritas	$25 - $134	23%
Carolina Complete Health	$25 - $136	23%
Healthy Blue	$25 - $136	23%
Partners	$25 - $132	23%
Trillium	$25 - $140	23%
UnitedHealthcare	$25 - $505	23%
Vaya	$25 - $137	23%
Wellcare	$25 - $136	23%
Cigna	$26 - $757	24%
Aetna	$27 - $729	25%
Humana	$27 - $102	25%
Blue Cross Blue Shield	$54 - $388	51%
Choicecare	$57 - $776	53%
Medcost	$75 - $627	70%
Ambetter / Centene	$302 - $344	283%
Employers Health Network	$418	391%
Physician Reach Out	$473	443%
Magellan	$568	532%
Gmmi	$615	576%
Quik Trip	$615	576%
Carolina Behavioral Health	$681 - $757	638%
Healthgram	$757	709%
First Health	$804	753%
Lifesynch Community Choice Care	$804	753%
Private Health Care Systems	$852	798%
Beechstreet	$871	815%
Multiplan	$899	842%

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 $473.
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 Atrium Health Cleveland 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.