CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Holy Family Memorial

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $427
  • Cash Discount Price: $351
  • vs. Medicare Baseline: 4.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Holy Family Memorial is $427. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $351. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.00x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$351

Average discount available for prompt cash payment at this facility.

Insurance Median
$427

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: $351 (329%)
Insurance Median: $427 (400%)
Cash: $351 (329% of Medicare)
Ins. Median: $427 (400% 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 400% of the Medicare baseline (a markup of 300%). 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
Blue Cross Blue Shield $101 - $579 95%
Community Care Incorporated $101 95%
Health Partners $101 - $415 95%
Humana $101 95%
Icare $101 95%
Molina $101 - $109 95%
Network Health Plan $101 - $434 95%
Security Health Plan $101 - $511 95%
UnitedHealthcare $101 - $647 95%
Allwell $103 96%
Medical College Of Wisconsin $211 198%
Centivo $256 - $294 240%
Dean Health Plan $320 300%
Health Payment Systems $360 337%
Sheboygan Employers Health Network $383 359%
Chorus Community Health Plan $411 385%
Trilogy $422 395%
Cigna $460 431%
Wps Health Plan $473 443%
Aspirus $511 478%
Healtheos $511 478%
Multiplan/Private Healthcare Systems $511 478%
Preferred One $511 478%
Healthsmart $530 496%
First Health Network $562 526%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals