CMS Price Transparency Data

Ultrasound, pelvis

Facility: Childrens Hospital of Wisconsin

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $757
  • Cash Discount Price: $492
  • vs. Medicare Baseline: 7.09x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Childrens Hospital of Wisconsin is $757. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $492. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.09x the Medicare baseline. Located in 9000 W Wisconsin Ave, Milwaukee, WI.
Cash / Self-Pay
$492

Average discount available for prompt cash payment at this facility.

Insurance Median
$757

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: $492 (461%)
Insurance Median: $757 (709%)
Cash: $492 (461% of Medicare)
Ins. Median: $757 (709% 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 709% of the Medicare baseline (a markup of 609%). 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
Froedtert Health $627 - $761 587%
Medical College Of Wisconsin $627 587%
Network Health Plan $637 596%
UnitedHealthcare $658 - $681 616%
Aspirus Health Plan $671 628%
Common Ground Healthcare Cooperative $671 - $761 628%
Trilogy Health Solutions $671 - $761 628%
Wps Health Plan $680 - $806 637%
Advocate Aurora Healthcare $689 645%
Blue Cross Blue Shield $698 - $850 653%
Centivo $698 653%
Health Partners $698 - $788 653%
Employer Health Care Alliance Cooperative $703 658%
Dean Health Plan $716 670%
Group Health Cooperative Of Eau Claire $716 670%
Oan Llc $716 670%
Security Health Plan $743 696%
Health Payment Systems $757 709%
Praire States $761 712%
Quartz Health Insurance $761 712%
Sheboygan Employer'S Health Network $761 712%
Mayo Clinic Health Solutions $779 729%
Aetna $788 - $797 738%
Bellin Thedacare $806 755%
Cigna $806 755%
Group Health Cooperative Of South Central Wisconsin $806 755%
Prevea Health Network $806 755%
Multiplan $815 - $850 763%
Coventry Health Care $850 796%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9000 W Wisconsin Ave, Milwaukee, WI 53226
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens