CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Boone Memorial Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $164
Cash Discount Price: $293
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Boone Memorial Hospital is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $293. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.54x the Medicare baseline. Located in 701 Madison Avenue, Madison, WV.

Cash / Self-Pay

$293

Average discount available for prompt cash payment at this facility.

Insurance Median

$164

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: $293 (274%)

Insurance Median: $164 (154%)

Cash: $293 (274% of Medicare)

Ins. Median: $164 (154% 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
Medicare (plans)	$50 - $161	47%
Humana	$161	151%
Aetna	$164 - $556	154%
Blue Cross Blue Shield	$164	154%
Medicaid / KanCare	$176	165%
Cigna	$436	408%

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 $293.
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 Boone Memorial 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.