CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Osceola Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $2,058
Cash Discount Price: $5,674
vs. Medicare Baseline: 19.27x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Osceola Hospital is $2,058. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,674. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.27x the Medicare baseline. Located in 700 West Oak Street, Kissimmee, FL.

Cash / Self-Pay

$5,674

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,058

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: $5,674 (5312%)

Insurance Median: $2,058 (1927%)

Cash: $5,674 (5312% of Medicare)

Ins. Median: $2,058 (1927% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 1927% of the Medicare baseline (a markup of 1827%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
United	$245 - $2,773	229%
Freedom Health	$377 - $444	353%
Optimum	$377 - $444	353%
Avmed	$419 - $3,081	392%
Simply	$807 - $949	756%
Molina Healthcare	$996 - $1,664	932%
Corvel Corporation	$1,037	971%
Prime Health	$1,059	991%
Careworks (Rockport Community)	$1,091	1021%
Sunshine State Health Plan	$1,336 - $1,571	1251%
Humana	$1,468 - $1,725	1374%
Aetna	$1,572 - $1,848	1472%
Plotkin Health	$2,621 - $3,081	2454%
Prime Health Sheriff	$2,621 - $3,081	2454%
Multiplan	$3,931 - $5,237	3680%
Evernorth	$4,193 - $4,929	3926%
Ppo Next	$4,455 - $5,237	4171%
Novanet	$4,717 - $5,545	4416%
Beacon Health Options	$5,241 - $6,161	4907%

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 $5,674.
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 HCA Florida Osceola 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.