CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $62
Cash Discount Price: $196
vs. Medicare Baseline: 0.58x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Alice Peck Day Memorial Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $196. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.58x the Medicare baseline. Located in 10 Alice Peck Day Drive, Lebanon, NH.

Cash / Self-Pay

$196

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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: $196 (184%)

Insurance Median: $62 (58%)

Cash: $196 (184% of Medicare)

Ins. Median: $62 (58% 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
Ambetter / Centene	$20	19%
Nh Healthy Families	$20	19%
Medicaid / KanCare	$28 - $305	26%
Blue Cross Blue Shield	$30 - $592	28%
Harvard Pilgrim	$38 - $577	36%
UnitedHealthcare	$44 - $479	41%
Tufts	$45 - $488	42%
Cigna	$47 - $544	44%
Commercial Generic	$47 - $509	44%
Connecticut General	$47 - $509	44%
Klais	$47 - $514	44%
Aetna	$55 - $598	51%
Mvp	$56 - $605	52%
Coventry Health	$58 - $632	54%
Coventry Health Wc	$58 - $632	54%
Wellpoint	$61 - $478	57%
Humana	$63 - $692	59%

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 $196.
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 Alice Peck Day Memorial 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.