CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Pasadena Hospital A Part of HCA Florid

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $950
Cash Discount Price: $3,669
vs. Medicare Baseline: 8.89x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Pasadena Hospital A Part of HCA Florid is $950. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,669. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.89x the Medicare baseline. Located in 1501 Pasadena Ave S, Saint Petersburg, FL.

Cash / Self-Pay

$3,669

Average discount available for prompt cash payment at this facility.

Insurance Median

$950

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: $3,669 (3435%)

Insurance Median: $950 (889%)

Cash: $3,669 (3435% of Medicare)

Ins. Median: $950 (889% 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 889% of the Medicare baseline (a markup of 789%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$159 - $186	149%
Access 2 Healthcare Physicians Freedom Health	$244 - $284	228%
Access 2 Healthcare Physicians Optimum	$244 - $284	228%
United	$245 - $1,776	229%
Freedom Health Care	$265 - $308	248%
Optimum Healthcare	$265 - $308	248%
Avmed	$271 - $987	254%
Simply Healthcare	$522 - $608	489%
Molina	$644 - $1,066	603%
Sunshine State Health Plan	$865 - $1,007	810%
Humana	$950 - $1,105	889%
Aetna	$1,017 - $1,184	952%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Evolutions Healthcare Systems	$1,696 - $3,632	1588%
Plotkin Health	$1,696 - $1,974	1588%
Prime Health Sheriff	$1,696 - $1,974	1588%
Multiplan	$2,544 - $3,355	2382%

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 $3,669.
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 Pasadena Hospital A Part of HCA Florid 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.