CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Hospital for Special Surgery

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $476
Cash Discount Price: $483
vs. Medicare Baseline: 4.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Hospital for Special Surgery is $476. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $483. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.46x the Medicare baseline. Located in 535 East 70Th Street, New York, NY.

Cash / Self-Pay

$483

Average discount available for prompt cash payment at this facility.

Insurance Median

$476

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: $483 (452%)

Insurance Median: $476 (446%)

Cash: $483 (452% of Medicare)

Ins. Median: $476 (446% 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 446% of the Medicare baseline (a markup of 346%). 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
UnitedHealthcare	$21 - $771	20%
Fidelis	$23 - $24	22%
Emblem	$30 - $40	28%
Metro Plus	$30 - $31	28%
Blue Cross Blue Shield	$40 - $514	37%
Horizon	$49	46%
Nyship	$53	50%
Cigna	$61 - $587	57%
Aetna	$72 - $719	67%
Fidelis Essential [1323]	$91	85%
Affinity By Molina Health Plan [1005]	$95 - $728	89%
Christian Brothers [1034]	$95 - $719	89%
Connecticare [1039]	$95 - $476	89%
Medicare (plans)	$95	89%
Meritain Health [1085]	$95 - $719	89%
Nippon Life [1092]	$95 - $719	89%
Webtpa [1356]	$95 - $719	89%
Oxford [1096]	$422 - $544	395%
Emblem Health [1043]	$476 - $520	446%
Apwu [1016]	$499 - $587	467%
Nalc [1090]	$499 - $587	467%
Qualcare [1101]	$499 - $587	467%
Wellfleet [1361]	$499 - $587	467%
Student Resources [1103]	$520 - $671	487%
Harvard Pilgrim [1057]	$598 - $771	560%
Geha [1053]	$671	628%

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 $483.
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 Hospital for Special Surgery 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.