CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Oakleaf Surgical Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $104
  • Cash Discount Price: $800
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Oakleaf Surgical Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $800. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 1000 Oakleaf Way, Altoona, WI.
Cash / Self-Pay
$800

Average discount available for prompt cash payment at this facility.

Insurance Median
$104

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: $800 (749%)
Insurance Median: $104 (97%)
Cash: $800 (749% of Medicare)
Ins. Median: $104 (97% 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.

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 $104 - $389 97%
Dean Health Plan $104 97%
Group Health Cooperative Of Eau Claire $104 97%
Healthpartners $104 97%
Humana $104 97%
Medica $104 97%
Quartz Health Solutions $104 97%
Security Health Plan Of Wi $104 - $876 97%
Ucare Wi $104 97%
UnitedHealthcare $104 97%

Consumer Guidance & Cost Commentary

For an Ultrasound, abdomen (limited) procedure at Oakleaf Surgical Hospital in Altoona, WI, the cash median price is $800. This facility is a physician-owned acute care hospital, and while the cash rate is significantly lower than the gross charge of $888, it is important to note that commercial insurance negotiated rates can sometimes exceed the cash price. For instance, Blue Cross Blue Shield has a high-end negotiated rate of $389, which is higher than the $800 cash option. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, provided they verify the specific negotiated rates with their insurer, as some plans could result in out-of-pocket costs higher than $800 if the deductible has not been met.

To ensure you are receiving the most accurate pricing information, it is recommended to request an itemized billing audit before finalizing any payment. This process involves reviewing a detailed, line-by-line statement of charges to identify potential errors, double-billing, or unbundled codes that could inflate your total cost, as over 80% of hospital bills contain such errors. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which are fee reductions typically ranging from 20% to 50% offered for upfront payments that bypass costly insurance claims processing. While the data provided does not include specific county or state average comparisons for this procedure, understanding that Medicare benchmarks for this service are $106.81 helps establish a baseline for evaluating the facility's pricing markup against national cost standards.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Oakleaf Way, Altoona, WI 54720
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals