CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Fort Memorial Hospital

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $102
Cash Discount Price: $239
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Fort Memorial Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$239

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $239 (224%)

Insurance Median: $102 (95%)

Cash: $239 (224% of Medicare)

Ins. Median: $102 (95% 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.

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
Mercycare	$34 - $913	32%
Blue Cross Blue Shield	$35 - $300	33%
Dean Health Plan	$36 - $851	34%
Humana	$36 - $181	34%
Molina	$36 - $116	34%
Quartz	$36 - $1,141	34%
UnitedHealthcare	$36 - $131	34%
Managed Health Services	$45 - $74	42%
Aetna	$58 - $919	54%
Medicaid / KanCare	$68	64%
Alliance	$98 - $880	92%
Medicare (plans)	$102	95%
Fort Care	$122 - $364	114%
Centivo	$123 - $500	115%
Veteran Evaluation Services	$127	119%
Group Health Cooperative	$154 - $793	144%
Trilogy	$223 - $1,078	209%
Cigna	$241 - $1,165	226%

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 $239.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Fort Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76700.
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.