Ultrasound, abdomen at Good Samaritan University Hospital. CPT 76700.
What Good Samaritan University Hospital publishes for this service, straight from its standard-charges file, last updated February 19, 2026.
Outpatient / ER
—cash price (self-pay)
$1,338list price
$60.60–$1,338range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Affinity Health Plan | CHP | $60.60 |
| Affinity Health Plan | HARP | $60.60 |
| Affinity Health Plan | MEDICAID | $60.60 |
| Centerlight Healthcare | MEDICAID | $60.60 |
| BCBS-NY Empire | MA | $123 |
| Aetna | Medicare | $126 |
| Centerlight Healthcare | PACE | $126 |
| Centers Plan For Healthy Living | Medicare | $126 |
| Agewell New York | Medicare HMO | $130 |
| Affinity Health Plan | EP 1&2 | $136 |
| Affinity Health Plan | EP 3&4 | $136 |
| Aetna | Narrow Network | $172 |
| APWU | Commercial | $194 |
| Centivo | PPO Cigna Medical | $194 |
| Cigna | Commercial | $194 |
| Daniel H Cook | Associates | $194 |
| Aetna | Commercial | $205 |
| BCBS-NY Empire | Blue Access Small Group | $231 |
| BCBS-NY Empire | Blue Access Large Group | $274 |
| American Plan Administrators | Commercial | $283 |
| Amerihealth Administrators | Commercial | $283 |
| Benefit Services | Commercial | $283 |
| BCBS-NY Empire | Commercial | $305 |
| Centivo | Commercial | $337 |
| Brighton | Create IDN | $404 |
| Brighton | Create Flex | $415 |
| Brighton | LOCAL 3 MAGNA JIB | $702 |
| Brighton | Direct Plus | $808 |
| Brighton | PPO | $808 |
| Allied Wellfare Fund | Commercial | $870 |
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