CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: St Josephs Community Hospital West Bend

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $656
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 6.14x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at St Josephs Community Hospital West Bend is $656. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.14x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$656

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: $573 (536%)
Insurance Median: $656 (614%)
Cash: $573 (536% of Medicare)
Ins. Median: $656 (614% 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 614% of the Medicare baseline (a markup of 514%). 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
Allwell $103 96%
Blue Cross Blue Shield $103 - $886 96%
Community Care $103 96%
Health Partners $103 - $677 96%
Humana $103 96%
Icare $103 96%
Molina $103 96%
Network Health Plan $103 - $434 96%
Security Health Plan Secure Savers $103 96%
UnitedHealthcare $103 - $647 96%
Aetna $105 - $729 98%
Care Wisconsin $106 99%
Centivo $313 - $344 293%
Froedtert South $438 410%
Chorus Community Health Plan $448 419%
Common Ground $625 585%
Health Payment Systems $656 - $842 614%
Sheboygan Employers Health Network $695 651%
Wisconsin Physician Services $834 781%
Trilogy $854 800%
Americas Choice $907 849%
Healtheos $907 849%
Multiplan/Private Healthcare Systems $907 849%
First Health Network $917 859%
Hfn $938 878%
Ibsi Passport $938 878%
Cigna $990 927%
Healthsmart $990 927%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals