CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: St Anthony Community Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $627
  • Cash Discount Price: $2,089
  • vs. Medicare Baseline: 5.87x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at St Anthony Community Hospital is $627. 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 5.87x the Medicare baseline. Located in 15 Maple Avenue -19, Warwick, NY.
Cash / Self-Pay
$2,089

Average discount available for prompt cash payment at this facility.

Insurance Median
$627

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: $627 (587%)
Cash: $2,089 (1956% of Medicare)
Ins. Median: $627 (587% 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 587% of the Medicare baseline (a markup of 487%). 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%
Tricare $130 122%
Mvp Gold (McR) $130 122%
Medicare (plans) $130 - $139 122%
Affinity By Molina McR $136 127%
Emblem $143 - $272 134%
Emblem Select Care (Exchange) $169 158%
Emblem Ghi/Hip PPO $199 186%
Cigna $233 - $1,462 218%
Mvp Exchange $248 232%
Geisinger Health Commercial/Exchange $429 402%
Mvp Hmo/Ppo $482 451%
Blue Cross Blue Shield $542 - $3,349 507%
Self-Pay $600 562%
Self-Pay - Cc 30% $627 587%
Aetna $940 - $1,044 880%
Cdphp $1,044 977%
Self-Pay - Cc 50% $1,044 977%
Oxford Commercial $1,319 1235%
PHCS $1,567 1467%
Multiplan $1,567 1467%
Emblem Ghi/Hip Hmo/Epo/Pos $1,671 1564%
UnitedHealthcare $1,687 - $1,985 1579%
Oxford Exchange $1,687 1579%
Magnacare Preferred $1,880 1760%
First Health $2,089 1956%
Mvp $18,190 - $21,438 17030%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15 Maple Avenue -19, Warwick, NY 10990
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals