CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $959
Cash Discount Price: $654
vs. Medicare Baseline: 8.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Carilion Stonewall Jackson Hospital is $959. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $654. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.98x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.

Cash / Self-Pay

$654

Average discount available for prompt cash payment at this facility.

Insurance Median

$959

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: $654 (612%)

Insurance Median: $959 (898%)

Cash: $654 (612% of Medicare)

Ins. Median: $959 (898% 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 898% of the Medicare baseline (a markup of 798%). 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
Blue Cross Blue Shield	$78 - $488	73%
Sentara Health Plan	$79 - $1,158	74%
Abh of VA (Formerly Coventry)	$82	77%
Abh of Wva (Formerly Coventry)	$82	77%
Humana	$82 - $100	77%
UnitedHealthcare	$82 - $1,527	77%
Aetna	$92 - $1,240	86%
Gateway - Tier 3	$1,027	962%
Vhn - Ultra	$1,158	1084%
Connecticare	$1,308	1225%
Gateway - Tier 2	$1,494	1399%
Vhn - Plus	$1,494	1399%
Cigna	$1,496	1401%
Integrated Health Plan	$1,588	1487%
Vhn	$1,588	1487%
Vhn - Link	$1,681	1574%
Beech Street	$1,719	1609%
Gateway - Tier 1	$1,775	1662%
Vhn - Secondary Payors	$1,775	1662%

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 $654.
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 Carilion Stonewall Jackson Hospital 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.