CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Highland Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $132
Cash Discount Price: $632
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Highland Hospital is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $632. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.24x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$632

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

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: $632 (592%)

Insurance Median: $132 (124%)

Cash: $632 (592% of Medicare)

Ins. Median: $132 (124% 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
Amerigroup (Bswny Alternate) [1720]	$40	37%
Excellus [2201]	$40 - $244	37%
Medicaid / KanCare	$40 - $177	37%
Molina Healthcare [5189], Molina Healthcare [1723]	$40	37%
UnitedHealthcare	$40 - $218	37%
Mvp [2900]	$46 - $398	43%
Aetna	$80 - $271	75%
Elderplan [1316]	$80	75%
Excellus Bc/Bs [2201]	$80 - $151	75%
Icircle [1728]	$80	75%
Martins Point [1205]	$80 - $130	75%
Medicare (plans)	$80 - $174	75%
Nascentia [1729]	$80	75%
Humana	$81 - $161	76%
Fidelis [5155]	$89 - $185	83%
Highmark Bc/Bs Of Western Ny [5143]	$101	95%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$116 - $281	109%
Blue Cross Blue Shield	$130 - $186	122%
Independent Health [5156]	$160 - $193	150%
Cigna	$194 - $398	182%
Capital District Physicians Health Plan (Cdphp) [5149]	$217 - $290	203%

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 $632.
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 Highland 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.