CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $627
Cash Discount Price: $871
vs. Medicare Baseline: 5.87x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Cook Childrens Medical Center Prosper is $627. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $871. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.87x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$871

Average discount available for prompt cash payment at this facility.

Insurance Median

$627

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: $871 (815%)

Insurance Median: $627 (587%)

Cash: $871 (815% of Medicare)

Ins. Median: $627 (587% 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 587% of the Medicare baseline (a markup of 487%). 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	$96 - $1,364	90%
Beacon	$135 - $867	126%
El Paso Health First	$135 - $867	126%
Health Plan W. Uhrip	$135	126%
Health Plan W/O Uhrip	$135 - $867	126%
Tx Children Health	$135 - $867	126%
Wellpoint	$141	132%
Blue Cross Blue Shield	$145 - $1,445	136%
Superior Health	$145	136%
Firstcare	$148 - $1,284	139%
United Community	$148 - $594	139%
UnitedHealthcare	$193 - $1,364	181%
S&W Health	$368 - $1,348	345%
Cigna	$373 - $1,364	349%
Healthscope	$373 - $1,364	349%
Imagine Health	$373 - $1,364	349%
Humana	$381 - $1,412	357%
Multiplan	$381 - $1,396	357%
First Health	$386 - $1,412	361%
Galaxy Health	$395 - $1,445	370%
Healthsmart	$395 - $1,445	370%
Usamco	$403 - $1,477	377%

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 $871.
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 Cook Childrens Medical Center Prosper 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.