CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: UPMC Hamot

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $277
Cash Discount Price: $651
vs. Medicare Baseline: 2.59x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at UPMC Hamot is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $651. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.59x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$651

Average discount available for prompt cash payment at this facility.

Insurance Median

$277

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: $651 (609%)

Insurance Median: $277 (259%)

Cash: $651 (609% of Medicare)

Ins. Median: $277 (259% 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 259% of the Medicare baseline (a markup of 159%). 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
Blue Cross Blue Shield	$93 - $650	87%
Upmc Health Plan	$105 - $208	98%
UnitedHealthcare	$110 - $276	103%
Aetna	$114 - $760	107%
Fidelis	$117	110%
Wellcare	$121	113%
Amerihealth Caritas	$126 - $149	118%
Cigna	$126 - $434	118%
Highmark Wholecare (Prev Gateway)	$126 - $542	118%
Pa Health & Wellness	$126 - $162	118%
Geisinger	$132	124%
Health Partners Plans (Jefferson Health Plan)	$144	135%
Univera	$163 - $477	153%
Independent Health	$166 - $222	155%
Upmc Work Partners	$295	276%
Intergroup	$705 - $868	660%
Multiplan	$760 - $868	712%

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 $651.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm UPMC Hamot is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76700.
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.