CMS Price Transparency Data

Ultrasound, pelvis

Facility: Baptist Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $112
Cash Discount Price: $176
vs. Medicare Baseline: 1.05x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at Baptist Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.05x the Medicare baseline. Located in 123 Baptist Way, Pensacola, FL.

Cash / Self-Pay

$176

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $176 (165%)

Insurance Median: $112 (105%)

Cash: $176 (165% of Medicare)

Ins. Median: $112 (105% 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
Aetna	$14 - $1,618	13%
Pensacola	$19 - $332	18%
UnitedHealthcare	$33 - $587	31%
Hospice Regency	$38 - $665	36%
Cigna	$59 - $2,216	55%
Hospice Emerald Coast	$62 - $1,108	58%
Escambia	$75 - $1,330	70%
Private Healthcare	$81 - $1,440	76%
Uwf Athletes	$81 - $1,440	76%
First Health	$87 - $1,540	81%
Wc Corvel	$89 - $2,105	83%
Choicecare	$94 - $1,662	88%
Mh Choicecare	$94 - $1,662	88%
Cha Health Plan	$106	99%
Hospice Covenant	$107	100%
Medicare (plans)	$107	100%
Humana	$109 - $127	102%
Healthspring Of Fl Al	$110	103%
Mh Sunshine Mcaid	$111	104%
Multiplan	$111 - $1,972	104%
Staywell	$111	104%
Sunshine Health	$111	104%
Mh Wellcare	$112	105%
Wellcare	$112	105%
Fl Community Care Ltc	$113	106%
Simply Healthcare Healthy Kids	$122	114%
Fl Blue	$160 - $611	150%
Bc Fl	$438	410%

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 $176.
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 Baptist 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.