CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Lexington Memorial Hospital Inc

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $338
Cash Discount Price: $382
vs. Medicare Baseline: 3.16x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Lexington Memorial Hospital Inc is $338. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $382. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.16x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$382

Average discount available for prompt cash payment at this facility.

Insurance Median

$338

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: $382 (358%)

Insurance Median: $338 (316%)

Cash: $382 (358% of Medicare)

Ins. Median: $338 (316% 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 316% of the Medicare baseline (a markup of 216%). 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
Amerihealth	$144 - $210	135%
Carolina Complete	$144	135%
Healthy Blue	$144	135%
Partners	$144	135%
UnitedHealthcare	$145 - $342	136%
Vaya	$145	136%
Wellcare	$145	136%
Alliance	$147	138%
Trillium	$148	139%
Medcost	$167 - $510	156%
Blue Cross Blue Shield	$211 - $338	198%
Aetna	$217 - $705	203%
Ambetter / Centene	$219	205%
Oscar	$244 - $336	228%
Cigna	$332 - $338	311%
Directnet	$451	422%
Healthgram Lexington Home Brands	$549	514%
Healthgram	$610	571%
Private Healthcare Systems	$626	586%
Beechstreet	$671	628%
Humana	$671	628%
Multiplan	$687	643%
National Provider Network	$687	643%

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 $382.
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 Lexington Memorial Hospital Inc 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.