CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: UPMC Kane

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $318
Cash Discount Price: $478
vs. Medicare Baseline: 2.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at UPMC Kane is $318. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $478. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.98x the Medicare baseline. Located in 4372 Route 6, Kane, PA.

Cash / Self-Pay

$478

Average discount available for prompt cash payment at this facility.

Insurance Median

$318

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: $478 (448%)

Insurance Median: $318 (298%)

Cash: $478 (448% of Medicare)

Ins. Median: $318 (298% 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 298% of the Medicare baseline (a markup of 198%). 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	$82 - $384	77%
Blue Cross Blue Shield	$86 - $396	81%
Highmark Wholecare (Prev Gateway)	$89 - $335	83%
Aetna	$90 - $339	84%
UnitedHealthcare	$91 - $431	85%
Amerihealth Caritas	$93 - $352	87%
Geisinger	$132	124%
PA Health & Wellness	$162	152%
Horizon Health Plan	$163 - $616	153%
Cigna	$163 - $19,811	153%
Multiplan	$175 - $660	164%
Intergroup	$186 - $704	174%
Health Coalition Partners	$186 - $704	174%
Focus Healthcare	$221 - $836	207%
UPMC Work Partners	$273	256%

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 $478.
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 Kane 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.