CMS Price Transparency Data

Ultrasound, pelvis

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $107
  • Cash Discount Price: $372
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Cleveland Clinic Indian River Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.
Cash / Self-Pay
$372

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: $372 (348%)
Insurance Median: $107 (100%)
Cash: $372 (348% 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.

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 $26 - $679 24%
Blue Cross Blue Shield $30 - $764 28%
Avmed $32 - $244 30%
Careplus $32 - $107 30%
Magellan $32 - $509 30%
United $32 - $107 30%
Value Options $32 30%
Wellcare $32 - $107 30%
Freedom Health $34 - $107 32%
Independent Living Systems $34 - $112 32%
Wellmed $34 - $107 32%
Clear Spring Health $35 - $148 33%
Cigna $38 - $255 36%
Carelon Bh Strategies $107 100%
Humana $107 100%
Devoted Health $117 110%
Clarity Health $193 - $552 181%
The Legacy Companies $193 - $552 181%
National Provider Network $208 195%
Three Rivers $208 195%
Consociate Health $223 209%
Bmi $467 437%
Multiplan $679 636%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 36Th St, Vero Beach, FL 32960
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals