CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Sarasota Doctors Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,512
Cash Discount Price: $5,931
vs. Medicare Baseline: 14.16x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Sarasota Doctors Hospital is $1,512. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,931. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.16x the Medicare baseline. Located in 5731 Bee Ridge Rd, Sarasota, FL.

Cash / Self-Pay

$5,931

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,512

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: $5,931 (5553%)

Insurance Median: $1,512 (1416%)

Cash: $5,931 (5553% of Medicare)

Ins. Median: $1,512 (1416% 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 1416% of the Medicare baseline (a markup of 1316%). 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 - $2,669	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$279	261%
Access 2 Healthcare Physicians Freedom Health	$427	400%
Access 2 Healthcare Physicians Optimum	$427	400%
Freedom Health Care	$463	433%
Optimum Healthcare	$463	433%
Avmed	$474 - $1,483	444%
Simply Healthcare	$913	855%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Molina	$1,127 - $1,601	1055%
Sunshine State Health Plan	$1,512	1416%
Humana	$1,661	1555%
Aetna	$1,779	1666%
Behealthy America	$2,313	2166%
Beacon Health Options	$2,965	2776%
Healthcare Sarasota	$2,965	2776%
Plotkin Health	$2,965	2776%
Prime Health Sheriff	$2,965	2776%
Evolutions Healthcare Systems	$3,262 - $5,456	3054%
Multiplan	$4,448 - $5,041	4164%
Evernorth	$4,745	4442%

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 $5,931.
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 Sarasota Doctors 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.