CMS Price Transparency Data

Echocardiogram (heart ultrasound)

Facility: St Josephs Community Hospital West Bend

Billing Code: 93306 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93306
Insurance Median: $1,478
Cash Discount Price: $1,290
vs. Medicare Baseline: 2.65x Medicare

The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at St Josephs Community Hospital West Bend is $1,478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,290. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 2.65x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.

Cash / Self-Pay

$1,290

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,478

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: $1,290 (231%)

Insurance Median: $1,478 (265%)

Cash: $1,290 (231% of Medicare)

Ins. Median: $1,478 (265% 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 265% of the Medicare baseline (a markup of 165%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

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

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Network Health Plan	$515 - $573	92%
Allwell	$532	95%
Blue Cross Blue Shield	$532 - $1,994	95%
Community Care	$532	95%
Health Partners	$532 - $1,525	95%
Humana	$532	95%
Icare	$532	95%
Molina	$532	95%
Security Health Plan Secure Savers	$532	95%
UnitedHealthcare	$532 - $847	95%
Aetna	$543 - $1,642	97%
Care Wisconsin	$548	98%
Centivo	$704 - $774	126%
Froedtert South	$985	176%
Sheboygan Employers Health Network	$1,000	179%
Chorus Community Health Plan	$1,009	181%
Common Ground	$1,408	252%
Health Payment Systems	$1,478 - $1,897	265%
Wisconsin Physician Services	$1,877	336%
Trilogy	$1,924	345%
Americas Choice	$2,041	366%
Healtheos	$2,041	366%
Multiplan/Private Healthcare Systems	$2,041	366%
First Health Network	$2,064	370%
Hfn	$2,111	378%
Ibsi Passport	$2,111	378%
Cigna	$2,229	399%
Healthsmart	$2,229	399%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $1,290.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93306.

Insurance In-Network Protection Plan

Contact your insurance company to confirm St Josephs Community Hospital West Bend is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93306.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.