CMS Price Transparency Data

Ultrasound, pelvis

Facility: Sarasota Memorial Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $108
Cash Discount Price: $514
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Sarasota Memorial Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $514. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.01x the Medicare baseline. Located in 1700 S Tamiami Trl, Sarasota, FL.

Cash / Self-Pay

$514

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: $514 (481%)

Insurance Median: $108 (101%)

Cash: $514 (481% 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.

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
Molina Oncology	$24 - $54	22%
Simply Healthcare Oncology	$24 - $53	22%
Sunshine State Oncology	$24 - $53	22%
Amerihealth Caritas Oncology	$25 - $55	23%
Community Care Plan Oncology	$25 - $55	23%
Florida Community Care Oncology	$30 - $85	28%
Blue Cross Blue Shield	$31 - $114	29%
UnitedHealthcare	$34 - $1,102	32%
Wellcare Oncology	$34 - $73	32%
Simply Freedom Optimum Oncology	$36 - $76	34%
Aetna	$37 - $1,174	35%
Oscar Oncology	$55 - $116	51%
Ambetter / Centene	$85 - $288	80%
Simply Healthcare	$105 - $111	98%
Sunshine State	$111	104%
Simply Freedom Optimum	$112	105%
Wellcare	$112	105%
Molina	$114	107%
Amerihealth Caritas	$116	109%
Community Care Plan	$116	109%
Florida Community Care	$116 - $117	109%
Avmed	$804 - $1,072	753%
Usa Managed Care	$882 - $1,174	826%
First Health	$915 - $1,218	857%
Careworks	$1,146	1073%
Enlyte	$1,146	1073%

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 $514.
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 Sarasota Memorial 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.