CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: UPMC Presbyterian Shadyside

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $996
Cash Discount Price: $1,274
vs. Medicare Baseline: 9.32x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at UPMC Presbyterian Shadyside is $996. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,274. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.32x the Medicare baseline. Located in 200 Lothrop Street, Pittsburgh, PA.

Cash / Self-Pay

$1,274

Average discount available for prompt cash payment at this facility.

Insurance Median

$996

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: $1,274 (1193%)

Insurance Median: $996 (932%)

Cash: $1,274 (1193% of Medicare)

Ins. Median: $996 (932% 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 932% of the Medicare baseline (a markup of 832%). 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
UnitedHealthcare	$69 - $109	65%
Upmc Health Plan	$105 - $996	98%
Amerihealth Caritas	$109 - $151	102%
Cigna	$109	102%
Highmark Wholecare (Prev Gateway)	$109 - $1,062	102%
Pa Health & Wellness	$109 - $162	102%
Aetna	$112 - $531	105%
Blue Cross Blue Shield	$136 - $901	127%
Health Partners Plans (Jefferson Health Plan)	$144	135%
Geisinger	$148	139%
Upmc Work Partners	$297	278%
Multiplan	$345 - $1,699	323%
Preferred Healthcare System	$1,381	1293%
Coventry/First Health	$1,487	1392%
Fidelis	$1,593	1491%
Intergroup	$1,593 - $1,805	1491%
Health Coalition Partners	$1,699	1591%
Private Health Care Systems	$1,699	1591%
Selectcare	$1,699	1591%
Health Payors Organization	$1,805	1690%
Humana	$1,805	1690%

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 $1,274.
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 Presbyterian Shadyside 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.