CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: CHI St Lukes Health Memorial San Augustine

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $211
Cash Discount Price: $521
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at CHI St Lukes Health Memorial San Augustine is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $521. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.98x the Medicare baseline. Located in 511 Hospital St, San Augustine, TX.

Cash / Self-Pay

$521

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $521 (488%)

Insurance Median: $211 (198%)

Cash: $521 (488% of Medicare)

Ins. Median: $211 (198% 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.

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	$97 - $868	91%
Humana	$97 - $2,429	91%
Wellpoint	$100 - $207	94%
Cigna	$102 - $357	95%
Blue Cross Blue Shield	$106 - $335	99%
United	$106 - $3,470	99%
Scanhealth	$108	101%
Md Save	$121	113%
Superior	$132 - $207	124%
Tchp	$135	126%
Angelina County	$265	248%
Brookshire Brothers	$291	272%
PHCS	$2,360 - $2,776	2210%
Multiplan	$2,429	2274%
Galaxy	$3,123	2924%
Entrust	$3,609	3379%

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 $521.
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 CHI St Lukes Health Memorial San Augustine 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.