CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $673
  • Cash Discount Price: $2,089
  • vs. Medicare Baseline: 6.30x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Good Samaritan Hospital of Suffern is $673. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,089. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.30x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.
Cash / Self-Pay
$2,089

Average discount available for prompt cash payment at this facility.

Insurance Median
$673

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: $2,089 (1956%)
Insurance Median: $673 (630%)
Cash: $2,089 (1956% of Medicare)
Ins. Median: $673 (630% 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 630% of the Medicare baseline (a markup of 530%). 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
Hamaspik (McR) $130 122%
Medicare (plans) $130 - $139 122%
Mvp Gold (McR) $130 122%
Tricare $130 122%
Affinity By Molina McR $136 127%
Beacon Exchange $156 146%
Beacon Commercial $169 158%
Emblem $187 - $396 175%
Emblem Select Care (Exchange) $259 242%
Emblem Ghi/Hip PPO $305 286%
Cigna $308 - $1,462 288%
Mvp Exchange $325 304%
Geisinger Health Commercial/Exchange $429 402%
Self-Pay - Cc 30% $627 587%
Mvp Hmo/Ppo $632 592%
Blue Cross Blue Shield $667 - $4,120 624%
Self-Pay $738 691%
Aetna $940 - $1,044 880%
Cdphp $1,044 977%
Self-Pay - Cc 50% $1,044 977%
Oxford Commercial $1,319 1235%
Magnacare Standard $1,462 1369%
Multiplan $1,567 1467%
PHCS $1,567 1467%
Emblem Ghi/Hip Hmo/Epo/Pos $1,671 1564%
Oxford Exchange $1,687 1579%
UnitedHealthcare $1,687 - $1,985 1579%
First Health $1,776 1663%
Magnacare Preferred $1,880 1760%
Mvp $18,190 - $21,438 17030%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 Lafayette Avenue, Suffern, NY 10901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals