CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: St Nicholas Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76700
  • Insurance Median: $545
  • Cash Discount Price: $770
  • vs. Medicare Baseline: 5.10x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at St Nicholas Hospital is $545. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $770. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.10x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$770

Average discount available for prompt cash payment at this facility.

Insurance Median
$545

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $770 (721%)
Insurance Median: $545 (510%)
Cash: $770 (721% of Medicare)
Ins. Median: $545 (510% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $106.81 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 510% of the Medicare baseline (a markup of 410%). 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
Molina Healthcare $41 - $103 38%
Security Health Plan $42 - $744 39%
Blue Cross Blue Shield $72 - $696 67%
Community Care Family Care $72 67%
Managed Health Services $72 67%
Medicaid / KanCare $72 67%
Meridian Health Plan $72 67%
Triology $76 - $921 71%
Aetna $103 - $1,166 96%
Humana $103 - $991 96%
Medica $103 96%
Medicare (plans) $103 96%
UnitedHealthcare $103 - $545 96%
Naphcare $231 216%
P360 Small Group $482 451%
Prevea Health Network $482 451%
Molina Healthcare Of Wi $583 546%
Hshs Employees $632 592%
Arise Health Plan $700 655%
Wea Provider Network $723 - $840 677%
Cigna $816 764%
Interplan $816 764%
Network Health Plan $816 764%
Health Care Alliance $851 797%
Health Eos $874 818%
Healthsmart $874 818%
Wisconsin Physician Service $933 874%
Multiplan/Phcs $979 917%
Choicecare $991 928%
North Central Healthcare Alliance $1,073 1005%
First Health $1,108 1037%
Caterpillar, Inc. $1,166 1092%
Cofinity $1,166 1092%
Live360 $1,166 1092%

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