CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: UPMC Bedford Memorial

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $570
Cash Discount Price: $658
vs. Medicare Baseline: 5.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at UPMC Bedford Memorial is $570. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $658. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.34x the Medicare baseline. Located in 10455 Lincoln Highway, Everett, PA.

Cash / Self-Pay

$658

Average discount available for prompt cash payment at this facility.

Insurance Median

$570

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: $658 (616%)

Insurance Median: $570 (534%)

Cash: $658 (616% of Medicare)

Ins. Median: $570 (534% 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 534% of the Medicare baseline (a markup of 434%). 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
Aetna	$37 - $735	35%
Upmc Health Plan	$87 - $416	81%
UnitedHealthcare	$100 - $735	94%
Blue Cross Blue Shield	$101 - $459	95%
Amerihealth Caritas	$109 - $149	102%
Cigna	$109 - $735	102%
Highmark Wholecare (Prev Gateway)	$109 - $141	102%
Pa Health & Wellness	$109 - $162	102%
Geisinger	$132	124%
Health Partners Plans (Jefferson Health Plan)	$144	135%
Upmc Work Partners	$273	256%
Intergroup	$713 - $987	668%
Coventry/First Health	$768	719%
Preferred Healthcare System	$878	822%
Health Coalition Partners	$987	924%
Humana	$987	924%
Private Health Care Systems	$987	924%
Selectcare	$987	924%

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 $658.
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 Bedford Memorial 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.