Ultrasound · 76514

Ultrasound Scan Of Cornea To Determine Thickness

Medicare Payment (avg)
$7.84
What Medicare actually pays
Billed Charge (avg)
$45.99
What providers submit
Markup
5.9x
487% above Medicare rate
429.4K
Total Services
398.8K
Beneficiaries
23.7K
Providers
55
States with Data

Price Range Across States

Lowest State Avg
$4.92
Northern Mariana Islands
Highest State Avg
$9.24
New York

What You Might Pay

Est. Commercial Insurance
$24.26
Range: $16.98 – $33.96
Est. Cash / Self-Pay
$20.77
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

How we estimate these prices

These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Ultrasound procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.

Prices by State

State Medicare Payment Billed Charge
New York $9.24 $61.26
District of Columbia $9.02 $49.59
Alaska $8.94 $90.95
Maryland $8.73 $36.53
California $8.55 $51.25
New Jersey $8.52 $56.36
Connecticut $8.49 $79.56
Guam $8.24 $69.00
Hawaii $8.16 $38.82
Florida $7.91 $34.91
Massachusetts $7.87 $58.78
Illinois $7.84 $60.06
Virginia $7.78 $38.96
Rhode Island $7.76 $50.86
Colorado $7.68 $38.02
Nevada $7.66 $44.14
Pennsylvania $7.65 $47.07
Washington $7.64 $37.19
Puerto Rico $7.63 $13.46
Delaware $7.60 $42.06
Texas $7.58 $41.29
Michigan $7.57 $47.42
Montana $7.49 $30.35
Georgia $7.45 $48.89
Arizona $7.38 $32.57
New Hampshire $7.26 $44.19
Missouri $7.25 $39.28
Oregon $7.23 $36.85
Minnesota $7.19 $50.63
Louisiana $7.19 $51.67
Utah $7.13 $39.95
South Dakota $7.09 $34.12
South Carolina $7.07 $42.36
Kansas $7.07 $55.54
North Carolina $7.05 $36.52
Oklahoma $7.05 $37.46
Kentucky $7.03 $37.26
Indiana $7.03 $37.55
Wyoming $6.99 $33.79
Alabama $6.97 $36.95
Tennessee $6.97 $38.49
Ohio $6.96 $40.46
New Mexico $6.93 $47.96
Maine $6.86 $42.00
Nebraska $6.81 $39.28
North Dakota $6.75 $42.96
Mississippi $6.74 $41.34
Idaho $6.65 $31.44
Wisconsin $6.63 $93.21
Iowa $6.60 $50.30
Vermont $6.58 $31.86
West Virginia $6.55 $38.17
Arkansas $6.45 $30.33
U.S. Virgin Islands $6.35 $47.71
Northern Mariana Islands $4.92 $89.23

What the Data Says About Ultrasound Scan Of Cornea To Determine Thickness

Across 55 states with reporting providers, CPT code 76514 (Ultrasound Scan Of Cornea To Determine Thickness) shows a national average Medicare payment of $7.84 against an average billed charge of $45.99. That gap — a 5.9x markup, or 487% above the Medicare allowed amount — reflects chargemaster pricing, not what most insured patients actually pay. Medicare's negotiated rate is the statutory benchmark; commercial insurers typically settle between the two figures based on network contracts.

Ultrasound procedures like this one saw 429.4K services billed to Medicare in 2023 by 23.7K distinct providers, serving 398.8K unique beneficiaries. State-level variation is significant: Northern Mariana Islands reports the lowest average payment at $4.92, while New York reports the highest at $9.24. Geographic Practice Cost Indices (GPCIs) explain much of that spread — local malpractice premiums, practice expense, and physician work adjustments all shift the allowed amount even when the procedure is identical.

Applying RAND 2024 commercial-to-Medicare ratios specific to the Ultrasound category (2.24x), the estimated commercial insurance price lands near $24.26, with self-pay cash discounts commonly bringing the figure closer to $20.77. Uninsured patients facing the full billed charge have the strongest leverage to negotiate — the Hospital Price Transparency Rule (effective January 2021) requires providers to publish standard charges, cash rates, and payer-specific negotiated prices. This data is for educational reference; confirm coverage and out-of-pocket exposure with your insurer before any procedure.

Frequently Asked Questions

How much does Ultrasound Scan Of Cornea To Determine Thickness cost?

The national average Medicare payment for Ultrasound Scan Of Cornea To Determine Thickness (CPT 76514) is $7.84, while providers typically bill $45.99. Prices vary significantly by state, ranging from $4.92 to $9.24.

Why do providers charge more than Medicare pays?

Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.

How much does Ultrasound Scan Of Cornea To Determine Thickness cost with insurance?

With commercial insurance, Ultrasound Scan Of Cornea To Determine Thickness costs an estimated $24.26 on average (range: $16.98 – $33.96). Without insurance, the estimated cash price is $20.77. These estimates are based on RAND 2024 research on commercial-to-Medicare price ratios. Your actual cost depends on your insurer, plan, and provider.

Which state has the lowest cost for Ultrasound Scan Of Cornea To Determine Thickness?

Northern Mariana Islands has the lowest average Medicare payment for Ultrasound Scan Of Cornea To Determine Thickness at $4.92, while New York has the highest at $9.24. This $4.32 difference reflects geographic variation in healthcare costs, local cost of living, and provider market dynamics.

How many providers perform Ultrasound Scan Of Cornea To Determine Thickness?

Nationally, 23.7K providers billed Medicare for Ultrasound Scan Of Cornea To Determine Thickness in 2023, performing 429.4K total services for 398.8K beneficiaries across 55 states and territories.

What is the billed-to-Medicare markup for Ultrasound Scan Of Cornea To Determine Thickness?

Providers bill 5.9x what Medicare pays for Ultrasound Scan Of Cornea To Determine Thickness — a 487% markup. This gap between billed charges and actual payment is common across healthcare. Uninsured patients may face charges closer to the billed amount, while insured patients pay negotiated rates between the Medicare and billed figures.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial