CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Adena Pike Medical Center

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $617
  • Cash Discount Price: $409
  • vs. Medicare Baseline: 5.78x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Adena Pike Medical Center is $617. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $409. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.78x the Medicare baseline. Located in 100 Dawn Lane, Waverly, OH.
Cash / Self-Pay
$409

Average discount available for prompt cash payment at this facility.

Insurance Median
$617

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: $409 (383%)
Insurance Median: $617 (578%)
Cash: $409 (383% of Medicare)
Ins. Median: $617 (578% 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 578% of the Medicare baseline (a markup of 478%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $196 - $666 184%
Blue Cross Blue Shield $196 - $706 184%
Buckeye Community Health Plan $196 184%
Humana $196 - $777 184%
Medical Mutual Of Ohio $196 - $520 184%
Medigold $196 184%
Molina $196 184%
Care Source $200 187%
Gateway Health $270 253%
Molina Marketplace $322 301%
Care Source Just4Me $354 331%
Sidecar Health $540 506%
Ohio Ppo Connect $573 536%
The Health Plan $573 536%
Cigna $593 555%
Medical Mutual Of Ohio Supermed $617 578%
First Health $642 601%
Ohio Health Choice $651 609%
UnitedHealthcare $704 659%
Integrated Health Plan $769 720%
Healthsmart $777 727%
Multiplan/Private Healthcare Systems $777 727%
Three Rivers Network $777 727%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Dawn Lane, Waverly, OH 45690
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals