CMS Price Transparency Data

Ultrasound, pelvis

Facility: University of Wi Hospitals & Clinics Authority

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $841
Cash Discount Price: $867
vs. Medicare Baseline: 7.87x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at University of Wi Hospitals & Clinics Authority is $841. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $867. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.87x the Medicare baseline. Located in 600 Highland Avenue, Madison, WI.

Cash / Self-Pay

$867

Average discount available for prompt cash payment at this facility.

Insurance Median

$841

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: $867 (812%)

Insurance Median: $841 (787%)

Cash: $867 (812% of Medicare)

Ins. Median: $841 (787% 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 787% of the Medicare baseline (a markup of 687%). 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
Aetna	$107 - $1,159	100%
Blue Cross Blue Shield	$107 - $1,373	100%
Humana	$107	100%
Medicare (plans)	$107 - $109	100%
UnitedHealthcare	$107 - $905	100%
Alliance_Premier_Network	$690	646%
Mercycare	$717	671%
Triology	$737 - $881	690%
Security_Health_Plan	$780 - $918	730%
Employer'S_Coalition_On_Health	$795 - $1,113	744%
Alliance	$813	761%
Hfn	$824 - $1,113	771%
United_Healthcare	$828 - $1,227	775%
Beloit_Health_System	$838	785%
Aspirus_Health_Plan	$844	790%
Cigna	$867	812%
Health_Partners_Insurance	$881	825%
Health_Payment_Systems	$886	830%
Dean_Health_Plan	$925	866%
Medical_Associates	$954	893%
Wps	$1,001 - $1,103	937%
Employers_Healthcare_Coalition_Of_Wi	$1,012	947%
Aspirus_Network_Inc	$1,113	1042%
Chorus_Community	$1,156	1082%
Ghc_Eau_Claire_Health_Plan	$1,156	1082%
Multiplan	$1,156 - $1,329	1082%
Sheybogan_Employers_Health_Network	$1,156	1082%
Coventry	$1,228	1150%
Dean_Care	$1,228	1150%
Healthsmart	$1,272	1191%

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 $867.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76856.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Wi Hospitals & Clinics Authority is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76856.
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.