CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Citrus Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,703
Cash Discount Price: $6,744
vs. Medicare Baseline: 15.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Citrus Hospital is $1,703. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,744. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.94x the Medicare baseline. Located in 502 W Highland Blvd, Inverness, FL.

Cash / Self-Pay

$6,744

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,703

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: $6,744 (6314%)

Insurance Median: $1,703 (1594%)

Cash: $6,744 (6314% of Medicare)

Ins. Median: $1,703 (1594% 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 1594% of the Medicare baseline (a markup of 1494%). 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
United	$245 - $3,035	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$317	297%
Access 2 Healthcare Physicians Freedom Health	$405	379%
Access 2 Healthcare Physicians Optimum	$405	379%
Freedom Health Care	$438	410%
Optimum Healthcare	$438	410%
Avmed	$540 - $1,686	506%
Corvel Corporation	$978	916%
Rockport Healthcare Group	$978	916%
Prime Health	$998	934%
Molina	$1,281 - $1,821	1199%
Sunshine State Health Plan	$1,720	1610%
Humana	$1,888	1768%
Aetna	$2,023	1894%
Beacon Health Options	$3,372	3157%
Plotkin Health	$3,372	3157%
Prime Health Sheriff	$3,372	3157%
Evolutions Healthcare Systems	$4,047 - $6,205	3789%
Multiplan	$5,058 - $5,733	4736%
Evernorth	$5,395	5051%

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 $6,744.
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 HCA Florida Citrus 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.