CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Pennsylvania Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $609
  • Cash Discount Price: $1,248
  • vs. Medicare Baseline: 5.70x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Pennsylvania Hospital is $609. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,248. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.70x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$1,248

Average discount available for prompt cash payment at this facility.

Insurance Median
$609

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: $1,248 (1168%)
Insurance Median: $609 (570%)
Cash: $1,248 (1168% of Medicare)
Ins. Median: $609 (570% 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 570% of the Medicare baseline (a markup of 470%). 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
Gateway Health Plan $38 - $136 36%
Medicaid / KanCare $38 - $1,278 36%
Keystone Mercy Health Plan $48 45%
Upmc $56 - $1,278 52%
Health Partners $58 - $1,278 54%
Pa Medical Assistance $62 58%
UnitedHealthcare $74 - $1,278 69%
Blue Cross Blue Shield $91 - $1,278 85%
Keystone Hmo Proactive $91 85%
Ibc Commercial Hpn $94 88%
Medicare (plans) $109 - $112 102%
Philadelphia Va Medical Center $109 102%
Tricare $110 103%
Ibc $112 105%
Cigna $113 - $167 106%
Geisinger Health Plan $113 - $347 106%
Humana $113 - $1,022 106%
Pa Health And Wellness $115 - $180 108%
Penn Life (Living Independently For Elders) $115 108%
Aetna $116 - $1,278 109%
Clover Health Plan $118 110%
Keystone First $121 113%
Us Family Health Plan $126 118%
Elap $155 145%
Claims Watcher $175 - $197 164%
Oscar Health Plan $186 174%
Centivo $197 184%
Elap Services $203 190%
Horizon Nj Health $206 - $225 193%
Highmark $230 215%
Pgm - Regie De L'Assurance Maladie Quebec $280 - $294 262%
Penn Global Medicine $290 272%
Preferred Health Care Eliance $316 - $332 296%
Pgm - Kuwait Defense $426 - $575 399%
Devon $462 - $575 433%
Qualcare $462 - $486 433%
Coventry $487 - $652 456%
Pgm - Chop $487 - $511 456%
Wissahickon Hospice $487 - $511 456%
Healthamerica/Coventry $548 - $626 513%
Olympus $591 - $621 553%
First Health Global $608 - $639 569%
Urn-Cancer Resource Services $608 - $639 569%
Health Net $730 - $767 683%
Pgm - Royal Embassy Of Saudi Arabia $730 - $767 683%
Pgm - Embassy Of Qatar $791 - $831 741%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $791 - $831 741%
Pgm - Embassy Of The United Emirates/Ipc $852 - $895 798%
Devon Health Services Inc $974 - $1,022 912%
Health America/Ccn $974 - $1,022 912%
Intergroup $974 - $1,022 912%
Pgm - Kuwait Health Division $974 - $1,022 912%
Pgm - Kuwait Oil $974 - $1,022 912%
Preferred Care $974 - $1,022 912%
Commercial Other $1,217 - $1,278 1139%
Community Behavioral Health $1,217 - $1,278 1139%
International Pfs $1,217 - $1,278 1139%
Quest Behavioral Health $1,217 - $1,278 1139%
United Behavioral Health $1,217 - $1,278 1139%
Workers Compensation $1,217 - $1,278 1139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals