CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Children's Hospital of Philadelphia

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $998
Cash Discount Price: $2,983
vs. Medicare Baseline: 9.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Children's Hospital of Philadelphia is $998. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,983. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.34x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$2,983

Average discount available for prompt cash payment at this facility.

Insurance Median

$998

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: $2,983 (2793%)

Insurance Median: $998 (934%)

Cash: $2,983 (2793% of Medicare)

Ins. Median: $998 (934% 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 934% of the Medicare baseline (a markup of 834%). 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
Geisinger Medical Assistance	$51	48%
Highmark Wholecare	$56	52%
Horizon Nj Health	$159	149%
UnitedHealthcare	$430 - $495	403%
Medicaid / KanCare	$492	461%
Health Partners	$562	526%
Aetna	$785 - $1,492	735%
Upmc Medical Assistance	$814	762%
Geisinger Health Plan Commercial	$869	814%
Keystone First Chip	$925	866%
Keystone Health Plan East	$943	883%
Blue Cross Blue Shield	$1,053 - $1,195	986%
Jefferson Health Plans	$1,411	1321%
Cigna	$1,492	1397%
Highmark	$1,492	1397%
Qualcare	$1,641	1536%
First Health Network	$1,939	1815%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$2,387	2235%
Private Health Care Systems	$2,387	2235%
Choice Care Network	$2,685	2514%

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 $2,983.
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 Children's Hospital of Philadelphia 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.