CMS Price Transparency Data

Ultrasound, pelvis

Facility: Marshfield Medical Center - Weston

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $799
Cash Discount Price: $844
vs. Medicare Baseline: 7.48x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Marshfield Medical Center - Weston is $799. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $844. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.48x the Medicare baseline. Located in 3400 Ministry Parkway, Weston, WI.

Cash / Self-Pay

$844

Average discount available for prompt cash payment at this facility.

Insurance Median

$799

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: $844 (790%)

Insurance Median: $799 (748%)

Cash: $844 (790% of Medicare)

Ins. Median: $799 (748% 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 748% of the Medicare baseline (a markup of 648%). 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
Security Health Plan (Shp)	$384 - $525	360%
Blue Cross Blue Shield	$419 - $468	392%
Family Health Center (Fhc)	$444	416%
Amish/Mennonite	$488	457%
Sanford Health Plan	$488	457%
The Alliance	$532 - $741	498%
UnitedHealthcare	$585 - $733	548%
Group Health Cooperative Of Eau Claire	$728 - $799	682%
Besse Forest Products	$755	707%
Molina Healthcare Of Wi	$755	707%
Rice Lake School District	$755	707%
Wps Health Insurance	$786 - $857	736%
Medica Of Wi	$828 - $845	775%
Cigna	$835	782%
Healtheos By Multiplan Inc.	$835 - $844	782%
Corvel	$844	790%
First Health	$844	790%
Health Partners	$844	790%
Three Rivers Provider Network (Trpn)	$844	790%
Trilogy	$848 - $852	794%
Coventry	$852	798%
Health Smart	$852	798%
Rising Medical Work Comp	$861	806%

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 $844.
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 Marshfield Medical Center - Weston 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.