CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Helen Hayes Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $118
Cash Discount Price: $664
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Helen Hayes Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $664. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.10x the Medicare baseline. Located in 51 North Route 9W, West Haverstraw, NY.

Cash / Self-Pay

$664

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $664 (622%)

Insurance Median: $118 (110%)

Cash: $664 (622% of Medicare)

Ins. Median: $118 (110% 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
UnitedHealthcare	$40 - $98	37%
Affinity	$68	64%
Bc Empire	$68	64%
Better Health Fidelis	$68 - $125	64%
Capital District (Cdphp)	$79	74%
Emblem Health	$118	110%
Aetna	$125	117%
Cigna	$141	132%
Mvp	$171	160%
Oxford	$498	466%

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 $664.
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 Helen Hayes 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.