CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76705
  • Insurance Median: $535
  • Cash Discount Price: $553
  • vs. Medicare Baseline: 5.01x Medicare
The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Gundersen Moundview Hospital and Clinics is $535. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $553. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.01x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.
Cash / Self-Pay
$553

Average discount available for prompt cash payment at this facility.

Insurance Median
$535

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: $553 (518%)
Insurance Median: $535 (501%)
Cash: $553 (518% of Medicare)
Ins. Median: $535 (501% 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 501% of the Medicare baseline (a markup of 401%). 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
Amerigroup $47 44%
Blue Cross Blue Shield $337 - $1,341 316%
Iowa Total Care $337 316%
Managed Health Service $337 316%
Alliance $419 - $555 392%
Health Partners $496 - $952 464%
Security Health Plan $496 464%
Ucare $496 - $862 464%
UnitedHealthcare $509 477%
Dean Health Plan $535 501%
Quartz $588 551%
Wps $831 778%
Wps - Arise $831 778%
Aspirus Arise Health $895 838%
Humana $916 858%
Multiplan/Healtheos $949 - $1,035 888%
Coventry Health Care $1,024 959%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 W Lake St, Friendship, WI 53934
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals