CMS Price Transparency Data

Ultrasound, pelvis

Facility: Bellin Health Oconto Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $333
Cash Discount Price: $289
vs. Medicare Baseline: 3.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Bellin Health Oconto Hospital is $333. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $289. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.12x the Medicare baseline. Located in 820 Arbutus Ave, Oconto, WI.

Cash / Self-Pay

$289

Average discount available for prompt cash payment at this facility.

Insurance Median

$333

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: $289 (271%)

Insurance Median: $333 (312%)

Cash: $289 (271% of Medicare)

Ins. Median: $333 (312% 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 312% of the Medicare baseline (a markup of 212%). 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
Blue Cross Blue Shield	$151 - $389	141%
Community Care	$151	141%
Humana	$151	141%
My Choice	$151	141%
Network Health	$151 - $378	141%
UnitedHealthcare	$182 - $311	170%
Aetna	$222	208%
Cigna	$315 - $320	295%
Common Ground	$324 - $333	303%
Chorus Community Health Plan	$334	313%
Aspirus Arise	$348	326%
Healthsmart	$356	333%
Ihs(Claimsbridge)	$356	333%
Medical College Of Wi	$356	333%
Hps/Paymedix	$365 - $396	342%
Wps Insurance	$374	350%
Allied National	$378	354%
First Health	$378	354%
Galaxy Health	$378	354%
Three Rivers Provider Network	$400	374%
Trilogy	$400	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 $289.
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 Bellin Health Oconto Hospital 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.