Ultrasound, abdomen at St. Luke's Health Memorial San Augustine. CPT 76700.

What St. Luke's Health Memorial San Augustine publishes for this service, straight from its standard-charges file, last updated February 28, 2026.

Outpatient / ER

$521cash price (self-pay)

$3,470list price

$96.94–$3,609range insurers pay

Insurance plan	Negotiated rate
AETNA \| Medicare\|All Plans	$96.94
HUMANA \| Medicare\|All Plans	$96.94
Wellpoint \| Medicare\|All Plans	$99.85
CIGNA HEALTHSPRING \| Medicare\|All Other Plans	$102
CIGNA HEALTHSPRING \| Medicare\|PPO	$103
BCBS \| Medicare\|All Plans	$106
UNITED \| Medicare\|All Plans	$106
SCANHealth \| Medicare\|All Plans	$108
MD Save \| Commercial\|All Plans	$121
SUPERIOR \| Medicaid\|All Other Plans	$132
SUPERIOR \| Medicaid\|STARPLUS	$132
UNITED \| Medicaid\|All Other Plans	$132
UNITED \| Medicaid\|STAR	$132
Wellpoint \| Medicaid\|All Other Plans	$132
CIGNA HEALTHSPRING \| Medicaid\|STARPLUS	$135
TCHP \| Medicaid\|All Plans	$135
Wellpoint \| Medicaid\|STARPLUS	$136
BCBS \| Medicaid\|All Plans	$139
Wellpoint \| Commercial\|Exchange	$158
SUPERIOR \| Medicaid\|STAR	$207
Wellpoint \| Medicaid\|STAR	$207
BCBS-TX \| Commercial\|Blue Advantage HMO	$211
UNITED \| Medicaid\|STARPLUS	$236
Angelina County \| Commercial\|All Plans	$265
BCBS-TX \| Commercial\|Blue Premier	$290
Brookshire Brothers \| Commercial\|All Plans	$291
BCBS-TX \| Commercial\|HMO	$302
BCBS-TX \| Commercial\|PPO	$335
Cigna \| Commercial\|All Plans	$357
United \| Commercial\|Exchange	$625

$521cash price (self-pay)

$3,470list price

$868–$3,470range insurers pay

Insurance plan	Negotiated rate
Aetna \| Commercial\|All Plans	$868
Humana \| Commercial\|All Plans	$2,429
Multiplan \| Commercial\|All Plans	$2,429
PHCS \| Commercial\|All Plans	$2,776
Galaxy \| Commercial\|All Plans	$3,123
United \| Commercial\|Exchange	$3,470

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