CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $107
Cash Discount Price: $552
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cleveland Clinic Martin North Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$552

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $552 (517%)

Insurance Median: $107 (100%)

Cash: $552 (517% of Medicare)

Ins. Median: $107 (100% 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.

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	$25 - $664	23%
Avmed	$32 - $411	30%
Miami Childrens Health Plan	$32 - $107	30%
United	$32 - $252	30%
Careplus	$34 - $112	32%
Freedom Health	$34 - $112	32%
Independent Living Systems	$34 - $108	32%
Clear Spring Health	$35 - $151	33%
Cigna	$38 - $427	36%
Aetna	$40 - $1,031	37%
Multiplan	$48 - $154	45%
Humana	$107	100%
Wellcare	$107	100%
Devoted Health	$117	110%
Clarity Health	$193 - $745	181%
The Legacy Companies	$193 - $745	181%
Consociate Health	$223 - $860	209%
Bmi	$467	437%

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 $552.
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 Cleveland Clinic Martin North 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.