CMS Price Transparency Data

Echocardiogram (heart ultrasound)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 93306 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 93306
Insurance Median: $1,391
Cash Discount Price: $1,277
vs. Medicare Baseline: 2.49x Medicare

The contracted insurance negotiated median rate for a Echocardiogram (heart ultrasound) at Gundersen St Josephs Hospital and Clinics is $1,391. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,277. Compared to the federal Medicare reimbursement reference rate of $558.25, this hospital’s rate is 2.49x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.

Cash / Self-Pay

$1,277

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,391

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$558.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $558.25 (100%)

Cash / Self-Pay: $1,277 (229%)

Insurance Median: $1,391 (249%)

Cash: $1,277 (229% of Medicare)

Ins. Median: $1,391 (249% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $558.25 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 249% of the Medicare baseline (a markup of 149%). 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
Amerigroup	$202	36%
Security Health Plan	$431	77%
Ucare	$1,143 - $1,758	205%
Blue Cross Blue Shield	$1,165 - $1,600	209%
UnitedHealthcare	$1,165 - $1,536	209%
Quartz	$1,198	215%
Iowa Total Care	$1,245	223%
Managed Health Service	$1,245	223%
Alliance	$1,758 - $2,088	315%
Cigna	$1,802	323%
Aspirus Arise Health	$1,824	327%
Humana	$1,868	335%
Multiplan/Healtheos	$1,912 - $2,088	342%
Coventry Health Care	$2,088	374%

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 $1,277.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 93306.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gundersen St Josephs Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 93306.
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.