CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: St Joseph's Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $1,076
  • Cash Discount Price: $1,210
  • vs. Medicare Baseline: 10.07x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at St Joseph's Hospital is $1,076. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,210. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.07x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$1,210

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,076

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: $1,210 (1133%)
Insurance Median: $1,076 (1007%)
Cash: $1,210 (1133% of Medicare)
Ins. Median: $1,076 (1007% 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 1007% of the Medicare baseline (a markup of 907%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Cigna $172 161%
Molina Healthcare $220 - $336 206%
Meridian Health Plan $231 216%
Sae Hospice $336 315%
Blue Cross Blue Shield $336 315%
Aetna $336 - $1,174 315%
Clear Spring Health of Illinois $336 315%
UnitedHealthcare $336 - $1,680 315%
Humana $336 315%
Amish Community $470 440%
Naphcare $706 661%
Celtic Insurance Company $739 692%
Caterpillar, Inc. $742 695%
Claim Doc $840 786%
Hopetrust $840 786%
Wellfirst $1,076 1007%
First Health $1,242 1163%
Multiplan/Phcs $1,428 1337%
Healthlink $1,428 1337%
Provider Network of America $1,512 1416%
Healthcare Finest Network (Hfn) $1,512 1416%
Qtc Medical Group of Illinois $1,680 1573%
Current Health Solutions $1,680 1573%
Mental Health Network $1,680 1573%
Illinois Breast and Cervical Cancer Program $1,680 1573%
Consociate Group $1,680 1573%
Healthscope $1,680 1573%
Interplan $1,680 1573%
Health Alliance Medical Plans $1,680 1573%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals