CMS Price Transparency Data

Ultrasound, abdomen (complete)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 76700 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76700
Insurance Median: $784
Cash Discount Price: $859
vs. Medicare Baseline: 7.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (complete) at Gundersen St Josephs Hospital and Clinics is $784. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $859. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.34x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.

Cash / Self-Pay

$859

Average discount available for prompt cash payment at this facility.

Insurance Median

$784

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: $859 (804%)

Insurance Median: $784 (734%)

Cash: $859 (804% of Medicare)

Ins. Median: $784 (734% 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 734% of the Medicare baseline (a markup of 634%). 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	$71	66%
Security Health Plan	$290	272%
Blue Cross Blue Shield	$380 - $784	356%
Alliance	$419 - $1,255	392%
Iowa Total Care	$438	410%
Managed Health Service	$438	410%
Ucare	$769 - $1,183	720%
UnitedHealthcare	$784 - $1,034	734%
Quartz	$806	755%
Cigna	$1,213	1136%
Aspirus Arise Health	$1,228	1150%
Humana	$1,257	1177%
Multiplan/Healtheos	$1,287 - $1,405	1205%
Coventry Health Care	$1,405	1315%

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 $859.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76700.

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 76700.
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.