CMS Price Transparency Data

Ultrasound, pelvis

Facility: North Okaloosa Medical Center

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $122
  • Cash Discount Price: $934
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at North Okaloosa Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $934. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 151 Redstone Ave Se, Crestview, FL.
Cash / Self-Pay
$934

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $934 (874%)
Insurance Median: $122 (114%)
Cash: $934 (874% of Medicare)
Ins. Median: $122 (114% 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
Veterans Eval Services $101 95%
Tricare $104 97%
Amerigroup $105 98%
Medicaid / KanCare $105 98%
UnitedHealthcare $105 - $822 98%
Aetna $107 - $3,114 100%
Blue Cross Blue Shield $107 - $618 100%
Cigna $107 - $3,239 100%
Humana $107 - $113 100%
Medicare (plans) $107 100%
Simply Healthcare $107 - $113 100%
Node Champva $109 102%
Node Non Par Hospice Agree $109 102%
Node Va $109 102%
Evolutions $110 - $3,654 103%
Usa Managed Care Work Comp Fl $110 103%
Integral Health $111 104%
Wellcare $111 104%
Magellan Health $113 106%
Prime Health Work Comp Fl $113 106%
Amcomp Workers Comp $116 109%
Florida Department Of Corrections $118 110%
Prestige Health $122 114%
Node Us Dept Of Labor $136 127%
Oscar $202 189%
State Auto Insurance Fl $218 204%
Occunet $273 256%
Self Pay $747 - $1,121 699%
Corizon Health Inc $1,404 1314%
Phcs $3,737 3499%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 151 Redstone Ave Se, Crestview, FL 32539
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals