Ultrasound, abdomen at Good Samaritan Hospital (GSH). CPT 76700.
What Good Samaritan Hospital (GSH) publishes for this service, straight from its standard-charges file, last updated April 1, 2026.
Outpatient / ER
$707cash price (self-pay)
$1,178list price
$35.48–$1,178range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Aetna | Medicare Advantage | $82.32 |
| Allwell | MCR ADV/PPO/HMO | $82.32 |
| Anthem MCR | MCR ADV/PPO/HMO | $82.32 |
| Anthem MCR | Medicare Advantage | $82.32 |
| Anthem | MCR ADV/PPO/HMO | $82.32 |
| Cigna | Medicare Advantage | $82.32 |
| Humana | Medicare Advantage | $82.32 |
| United Healthcare | Medicare Advantage | $82.32 |
| Alliance Coal | Commercial | $110 |
| Indiana University | MCR ADV/PPO/HMO | $111 |
| MHS Ambetter | Commercial | $111 |
| CareSource | Commercial | $117 |
| Encore Prime | Commercial | $146 |
| Anthem | Medicaid | $155 |
| Caresource HIP | Medicaid | $155 |
| Caresource | Medicaid | $155 |
| Anthem HIP | HIP | $164 |
| BCBS | Medicare Advantage | $164 |
| Hope Trust | Commercial | $165 |
| Aetna | Commercial | $220 |
| Aetna | Medicaid | $274 |
| Anthem Pathways | Medicaid | $274 |
| Anthem | Trad/PPO/HMO | $446 |
| Direct Health | Direct Health | $479 |
| OneCare | Commercial | $484 |
| HealthLink | HMO | $553 |
| Anthem | HealthSync | $557 |
| HealthLink | PPO | $585 |
| Amish | Commercial | $589 |
| Anthem | Exchange | $672 |
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