CMS Price Transparency Data

Ultrasound, abdomen (limited)

Facility: Stoughton Hospital

Billing Code: 76705 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76705
Insurance Median: $196
Cash Discount Price: $419
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a Ultrasound, abdomen (limited) at Stoughton Hospital is $196. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $419. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.84x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$419

Average discount available for prompt cash payment at this facility.

Insurance Median

$196

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: $419 (392%)

Insurance Median: $196 (184%)

Cash: $419 (392% of Medicare)

Ins. Median: $196 (184% 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.

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
Healthnet Mcr Adv - All Plans	$22 - $347	21%
Tricare	$22 - $311	21%
Aetna	$26 - $1,110	24%
Dean Health Insurance Med Adv	$26 - $366	24%
Quartz Mcr Adv	$26 - $366	24%
Security Health/First Health - All Plans	$26 - $366	24%
UnitedHealthcare	$26 - $1,045	24%
Blue Cross Blue Shield	$29 - $1,136	27%
Humana	$33 - $1,175	31%
Quartz Health Solutions - All Other Lans	$58 - $529	54%
Alliance - All Plans	$75 - $757	70%
Medicaid / KanCare	$86 - $132	81%
Geha - All Plans	$163 - $980	153%
Cigna	$174 - $1,045	163%
Wisconsin Ppo Ppa Direct - All Plans	$174 - $1,045	163%
Dean Health Insurance Comm - All Other Plans	$184 - $570	172%
Dean Health Insurance Epo	$184 - $570	172%
Wps - All Plans	$1,175	1100%

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 $419.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76705.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Stoughton Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76705.
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.