CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: The McDowell Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $552
Cash Discount Price: $1,190
vs. Medicare Baseline: 5.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at The McDowell Hospital is $552. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,190. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.17x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$1,190

Average discount available for prompt cash payment at this facility.

Insurance Median

$552

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: $1,190 (1114%)

Insurance Median: $552 (517%)

Cash: $1,190 (1114% of Medicare)

Ins. Median: $552 (517% 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 517% of the Medicare baseline (a markup of 417%). 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	$150 - $167	140%
United	$152 - $645	142%
Wellcare	$154 - $172	144%
Amerihealth	$156 - $174	146%
Partners Health Management	$157 - $175	147%
Vaya Health	$157 - $175	147%
Apex Health	$225 - $251	211%
Cigna	$386 - $671	361%
Caresource	$495 - $552	463%
Medcost	$551 - $1,066	516%
Magellan	$675 - $752	632%
Magellan Behavioral Health	$675 - $752	632%
Aetna	$814 - $907	762%
Multiplan	$900 - $1,003	843%
Avalon Administrative Services	$957 - $1,066	896%
Prime Health	$990 - $1,129	927%

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 $1,190.
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 The McDowell 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.