CMS Price Transparency Data

Ultrasound, pelvis

Facility: Shands Jacksonville

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $424
  • Cash Discount Price: $592
  • vs. Medicare Baseline: 3.97x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Shands Jacksonville is $424. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $592. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.97x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$592

Average discount available for prompt cash payment at this facility.

Insurance Median
$424

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: $592 (554%)
Insurance Median: $424 (397%)
Cash: $592 (554% of Medicare)
Ins. Median: $424 (397% 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 397% of the Medicare baseline (a markup of 297%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $104 - $887 97%
Ameri-Plus Preferred Care $109 102%
Blue Cross Blue Shield $109 - $546 102%
Capital Health Plan $109 - $538 102%
Humana $109 - $915 102%
Beacon Health Strategies $112 105%
Careplus Health Plan $112 105%
Florida Health Care Plan $112 - $192 105%
UnitedHealthcare $114 - $241 107%
Devoted Health Plan $115 - $120 108%
Carelon Health $116 109%
Positive Healthcare Partners $117 - $120 110%
Florida Community Care $121 113%
Amerihealth Caritas Florida $126 118%
Community Care Plan $126 118%
Molina $126 - $139 118%
Simply Healthcare $127 119%
Wellcare Of Florida $128 120%
Florida Complete Care $136 127%
Wellpath $176 165%
Ambetter / Centene $177 166%
Volusia Health Network $452 423%
Northeast Florida State Hospital $474 444%
North Florida Evaluation & Treatment Center $506 474%
Centivo $592 554%
Avmed $605 566%
Disney Cruise Line $646 605%
Cigna $667 624%
Health First Health Plan $700 - $754 655%
Mental Health Associates $700 655%
Prime Health Services $754 - $807 706%
Florida Health Alliance $775 726%
Archbold Medical Center $807 756%
Genex $807 756%
Rockport Provider $807 756%
Corvel Corp $915 857%
First Health $915 857%
Florida Hospital Healthcare System $915 857%
Medsave Usa Tpa $915 857%
Fringe Benefits Coordinators $969 - $1,023 907%
Multiplan $969 907%
Novanet $969 907%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals