Ultrasound, abdomen at Roxborough Memorial Hospital. CPT 76700.
What Roxborough Memorial Hospital publishes for this service, straight from its standard-charges file, last updated September 1, 2026.
Outpatient / ER
$106cash price (self-pay)
$1,457list price
$57.50–$1,413range insurers pay
| Insurance plan | Negotiated rate |
|---|---|
| Health Partners Plan | Health Partners Plan Medicaid | $57.50 |
| Traditional Medicaid | Traditional Medicaid | $57.50 |
| Keystone | Keystone First Medicaid | $60.95 |
| UHC | UHC Medicaid | $64.98 |
| Humana Military Tricare | Humana Military Tricare | $85.50 |
| Health Partners Plan | Health Partners Plan Medicare | $107 |
| Independence Blue Cross | IBC Medicare | $107 |
| PA Health & Wellness | PA Health & Wellness Medicare & Duals | $107 |
| Traditional Medicare | Traditional Medicare | $107 |
| Tricare | Tricare | $107 |
| UHC | UHC Medicare | $107 |
| UHC | UHC Va Ccn | $107 |
| Providers Partner Health Plan | Provider Partners Health Plan | $110 |
| Keystone | Keystone First Medicare | $111 |
| Ally-Align Medicare | Ally-Align Medicare | $112 |
| Spartan | Spartan Plan | $112 |
| Auto Insurance | Auto Insurance | $118 |
| Worker Compensation | Worker Compensation | $121 |
| PA Health & Wellness | PA Health & Wellness Commercial Insurance Excha | $128 |
| Employer Direct Healthcare | Employer Direct Healthcare | $150 |
| Health Partners Plan | Health Partners Plan Exchange | $160 |
| Naphcare | Naphcare | $166 |
| UHC | UHC Exchange | $168 |
| UHC | UHC Commercial All Payer | $223 |
| Highmark | Highmark Commercial (02-01-2024 to 12-31-2026) | $233 |
| Cigna | Cigna Commercial (05-01-2023 to 12-31-2026) | $253 |
| Independence Blue Cross | IBC Commercial HMO PPO | $277 |
| Independence Blue Cross | IBC Indemnity | $277 |
| Independence Blue Cross | IBC PPACA | $305 |
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