CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $580
Cash Discount Price: $741
vs. Medicare Baseline: 5.43x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at UPMC Children's Hospital of Pittsburgh is $580. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $741. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.43x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.

Cash / Self-Pay

$741

Average discount available for prompt cash payment at this facility.

Insurance Median

$580

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: $741 (694%)

Insurance Median: $580 (543%)

Cash: $741 (694% of Medicare)

Ins. Median: $580 (543% 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 543% of the Medicare baseline (a markup of 443%). 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	$85 - $679	80%
Health Plan Of Upper Ohio Valley	$101 - $803	95%
Blue Cross Blue Shield	$108 - $618	101%
Amerihealth Caritas	$109 - $234	102%
Cigna	$109 - $679	102%
Upmc Health Plan	$144 - $371	135%
UnitedHealthcare	$149 - $580	140%
Health Partners Plans (Jefferson Health Plan)	$242	227%
Highmark Wholecare (Prev Gateway)	$252	236%
Pa Health & Wellness	$253	237%
Geisinger	$257 - $555	241%
Intergroup	$803 - $1,050	752%
Coventry/First Health	$988	925%
Saudi Armed Forces	$988	925%
Health Payors Organization	$1,050	983%
Multiplan	$1,050	983%
National Provider Network	$1,112	1041%
Private Health Care Systems	$1,112	1041%

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 $741.
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 Children's Hospital of Pittsburgh 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.