CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $1,248
Cash Discount Price: $851
vs. Medicare Baseline: 11.68x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Carilion Stonewall Jackson Hospital is $1,248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $851. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.68x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.

Cash / Self-Pay

$851

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,248

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: $851 (797%)

Insurance Median: $1,248 (1168%)

Cash: $851 (797% of Medicare)

Ins. Median: $1,248 (1168% 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 1168% of the Medicare baseline (a markup of 1068%). 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	$92 - $1,614	86%
Humana	$94 - $109	88%
Blue Cross Blue Shield	$100 - $488	94%
UnitedHealthcare	$101 - $1,987	95%
Sentara Health Plan	$103 - $1,507	96%
Abh of VA (Formerly Coventry)	$109	102%
Abh of Wva (Formerly Coventry)	$109	102%
Gateway - Tier 3	$1,337	1252%
Vhn - Ultra	$1,507	1411%
Connecticare	$1,702	1593%
Gateway - Tier 2	$1,945	1821%
Vhn - Plus	$1,945	1821%
Cigna	$1,947	1823%
Integrated Health Plan	$2,066	1934%
Vhn	$2,066	1934%
Vhn - Link	$2,188	2048%
Beech Street	$2,237	2094%
Gateway - Tier 1	$2,309	2162%
Vhn - Secondary Payors	$2,309	2162%

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 $851.
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 Carilion Stonewall Jackson Hospital 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.