CMS Price Transparency Data

Ultrasound, pelvis

Facility: Baptist Medical Center - Nassau

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $813
  • Cash Discount Price: $1,363
  • vs. Medicare Baseline: 7.61x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Baptist Medical Center - Nassau is $813. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,363. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.61x the Medicare baseline. Located in 1250 S 18Th St, Fernandina Beach, FL.
Cash / Self-Pay
$1,363

Average discount available for prompt cash payment at this facility.

Insurance Median
$813

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: $1,363 (1276%)
Insurance Median: $813 (761%)
Cash: $1,363 (1276% of Medicare)
Ins. Median: $813 (761% 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 761% of the Medicare baseline (a markup of 661%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Corvel $78 - $2,154 73%
Coventry Workers Comp $78 - $2,154 73%
Amerigroup Of Georgia $105 98%
Daniel Memorial $105 98%
Humana $105 98%
Nassaua County Sheriff'S Office $105 98%
Community Hospice Of Northeast Florida $107 100%
Pace $107 100%
Tomorrow'S Rainbow $107 100%
Va Ccn $107 100%
UnitedHealthcare $108 - $1,079 101%
Aetna $109 - $1,758 102%
Simply Healthcare Plans $111 - $126 104%
Simply Healthcare Plans - Cha $111 104%
Florida Community Care $112 - $116 105%
Devoted $113 106%
Amerihealth Caritas $116 109%
Sunshine State Health Plan $116 109%
United Community Plan $116 109%
Vivida Health $116 109%
Upmc $117 110%
Molina Healthcare Of Florida $125 117%
Ambetter / Centene $256 240%
Blue Cross Blue Shield $637 - $1,429 596%
Avmed $703 - $1,648 658%
Borland Groover $879 823%
Occunet $879 823%
Northeast Florida State Hospital $923 864%
Centivo $967 - $1,868 905%
Capital Health Plan $1,011 947%
Geo Group $1,099 1029%
Watchtower $1,209 1132%
Fscj Student Insurance $1,319 1235%
Savannah Grand Of Amelia Island $1,319 1235%
Cigna $1,363 - $1,679 1276%
Suddath Company $1,385 1297%
Medicaid / KanCare $1,429 1338%
Peach State Health Plan $1,429 1338%
Phcs $1,648 1543%
Evolutions Healthcare $1,978 1852%
Multiplan $1,978 1852%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1250 S 18Th St, Fernandina Beach, FL 32034
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals