CMS Price Transparency Data

Echocardiogram (heart ultrasound)

Facility: St Nicholas Hospital

Billing Code: 93306 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 93306
  • Insurance Median: $1,645
  • Cash Discount Price: $1,709
  • vs. Medicare Baseline: 2.95x Medicare
The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at St Nicholas Hospital is $1,645. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,709. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 2.95x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$1,709

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,645

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$558.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $558.25 (100%)
Cash / Self-Pay: $1,709 (306%)
Insurance Median: $1,645 (295%)
Cash: $1,709 (306% of Medicare)
Ins. Median: $1,645 (295% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $558.25 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 295% of the Medicare baseline (a markup of 195%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $186 - $2,590 33%
Community Care Family Care $186 33%
Managed Health Services $186 33%
Medicaid / KanCare $186 33%
Meridian Health Plan $186 33%
Molina Healthcare $197 - $2,590 35%
Triology $197 - $2,046 35%
Security Health Plan $214 - $2,616 38%
P360 Small Group $484 87%
Prevea Health Network $484 87%
Aetna $530 - $2,590 95%
Humana $530 - $2,590 95%
Medica $530 - $2,590 95%
Medicare (plans) $530 - $2,590 95%
UnitedHealthcare $530 - $2,590 95%
Naphcare $1,193 214%
Molina Healthcare Of Wi $1,295 232%
Hshs Employees $1,404 252%
Arise Health Plan $1,554 278%
Wea Provider Network $1,606 - $1,865 288%
Cigna $1,813 325%
Interplan $1,813 325%
Network Health Plan $1,813 325%
Health Care Alliance $1,891 339%
Health Eos $1,942 348%
Healthsmart $1,942 348%
Wisconsin Physician Service $2,072 371%
Multiplan/Phcs $2,176 390%
Choicecare $2,202 394%
North Central Healthcare Alliance $2,383 427%
First Health $2,460 441%
Caterpillar, Inc. $2,590 464%
Cofinity $2,590 464%
Live360 $2,590 464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Superior Ave, Sheboygan, WI 53081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals