CMS Price Transparency Data

Ultrasound, pelvis

Facility: Mease Dunedin Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $730
Cash Discount Price: $882
vs. Medicare Baseline: 6.83x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Mease Dunedin Hospital is $730. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $882. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.83x the Medicare baseline. Located in 601 Main St, Dunedin, FL.

Cash / Self-Pay

$882

Average discount available for prompt cash payment at this facility.

Insurance Median

$730

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: $882 (826%)

Insurance Median: $730 (683%)

Cash: $882 (826% of Medicare)

Ins. Median: $730 (683% 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 683% of the Medicare baseline (a markup of 583%). 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
Aetna	$92 - $1,198	86%
Clear Health Alliance	$106	99%
Baycareplus	$107	100%
Blue Cross Blue Shield	$107 - $1,470	100%
UnitedHealthcare	$107 - $1,323	100%
Humana	$109 - $133	102%
Freedom Health	$111	104%
Molina Healthcare	$111	104%
Simply Healthcare	$111 - $265	104%
Sunshine Health	$111	104%
Florida Community Care	$116	109%
Solis Health	$117	110%
Cigna	$123 - $1,470	115%
Wellcare	$149	140%
Ambetter / Centene	$240 - $1,470	225%
Molina	$265 - $869	248%
Freedom	$294	275%
Optimum	$294	275%
Careplus	$336	315%
Ultimate Health Plan	$441	413%
Avmed	$456 - $1,058	427%
Evolutions	$735 - $1,367	688%
First Health	$1,250	1170%
Multiplan	$1,323	1239%
United Behavioral Health	$1,470	1376%

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 $882.
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 Mease Dunedin 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.