CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: UPMC Passavant

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $255
Cash Discount Price: $1,040
vs. Medicare Baseline: 2.39x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at UPMC Passavant is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,040. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.39x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.

Cash / Self-Pay

$1,040

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $1,040 (974%)

Insurance Median: $255 (239%)

Cash: $1,040 (974% of Medicare)

Ins. Median: $255 (239% 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 239% of the Medicare baseline (a markup of 139%). 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
Upmc Health Plan	$69 - $94	65%
UnitedHealthcare	$72 - $112	67%
Highmark Wholecare (Prev Gateway)	$93 - $109	87%
Amerihealth Caritas	$98 - $109	92%
Blue Cross Blue Shield	$98 - $587	92%
Health Plan Of Upper Ohio Valley	$101 - $801	95%
Aetna	$106 - $112	99%
Pa Health & Wellness	$107 - $109	100%
Upmc Work Partners	$219	205%
Private Health Care Systems	$255 - $1,612	239%
Cigna	$589 - $693	551%
Coventry/First Health	$1,213	1136%
Intergroup	$1,438 - $1,560	1346%
Humana	$1,473 - $1,612	1379%
Multiplan	$1,473 - $1,612	1379%

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 $1,040.
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 UPMC Passavant 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.