CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Lexington Memorial Hospital Inc

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $453
  • Cash Discount Price: $511
  • vs. Medicare Baseline: 4.24x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Lexington Memorial Hospital Inc is $453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $511. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.24x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.
Cash / Self-Pay
$511

Average discount available for prompt cash payment at this facility.

Insurance Median
$453

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: $511 (478%)
Insurance Median: $453 (424%)
Cash: $511 (478% of Medicare)
Ins. Median: $453 (424% 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 424% of the Medicare baseline (a markup of 324%). 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
Amerihealth $193 - $281 181%
Carolina Complete $193 181%
Healthy Blue $193 181%
Partners $193 181%
UnitedHealthcare $194 - $458 182%
Vaya $194 182%
Wellcare $194 182%
Alliance $196 184%
Trillium $198 185%
Medcost $224 - $684 210%
Blue Cross Blue Shield $282 - $453 264%
Aetna $290 - $944 272%
Ambetter / Centene $293 274%
Oscar $327 - $450 306%
Cigna $445 - $453 417%
Directnet $604 565%
Healthgram Lexington Home Brands $736 689%
Healthgram $818 766%
Private Healthcare Systems $838 785%
Beechstreet $899 842%
Humana $899 842%
Multiplan $920 861%
National Provider Network $920 861%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Hospital Drive Po Box 1817, Lexington, NC 27293
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals