CMS Price Transparency Data

Ultrasound, pelvis

Facility: Hialeah Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $108
  • Cash Discount Price: $3,887
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Hialeah Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,887. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.01x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$3,887

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $3,887 (3639%)
Insurance Median: $108 (101%)
Cash: $3,887 (3639% of Medicare)
Ins. Median: $108 (101% 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.

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 $45 - $2,799 42%
Veterans Administration Mill Bill $72 67%
Avmed Broad Network $88 82%
Medicare (plans) $93 - $225 87%
UnitedHealthcare $98 - $108 92%
Humana $99 - $206 93%
Devoted Health $103 96%
Leon Health Inc $103 96%
Tricare $104 97%
Bristol Hospice- Miami Dade Llc $105 98%
Catholic Hospice $105 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $105 98%
Dimension Health Wc $105 98%
Employer Direct Healthcare $105 - $133 98%
Hcr Manor Care Services Of Fl $105 98%
Hospice Other $105 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $105 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $105 98%
Veterans Administration Vaccn $105 98%
Vitas Healthcare Hospice Corporation Of Fl $105 98%
Vitas Hospice Unit Agreement $105 98%
Workers Compensation $105 98%
Medicaid / KanCare $106 - $111 99%
Cigna $108 - $1,143 101%
Healthsun Health Plans $108 - $110 101%
Longevity Health Plan $109 102%
Imagine Health $122 114%
Florida Pace Centers $124 116%
Bright Health Management Commercial $126 118%
Self Pay/Uninsured $129 - $130 121%
Naphcare Inc $144 135%
Bc/Bs Of Fl Miami Dade Blue Select $148 139%
Oscar Health Plan Hix $151 141%
Avmed Exchange $183 171%
Bc/Bs Of Fl Health Options Hmo $192 180%
Bc/Bs Of Fl Network Blue $192 180%
Ambetter / Centene $194 182%
Bc/Bs Myblue Hmo Hix $196 184%
Molina Marketplace Program Exchange $199 186%
Bc/Bs Of Fl Ppo $203 190%
Bc/Bs Of Fl Simplyblue $206 193%
Auto Insurance $209 196%
Avmed Select Network $214 200%
Bc/Bs Of Fl Blue Select Exchange Non Par $214 200%
Amerihealth Caritas Next Exchange $225 211%
Bc/Bs Of Fl Phs $2,015 1887%
Dimensions International $2,527 2366%
First Health $2,643 2474%
Dimension Health Ppo $2,915 2729%
Commercial Non-Contracted $3,887 3639%
Self Pay - Mcd Pending 100 Percent $3,887 3639%
Single Case Agreement $3,887 3639%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals