CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Mercy Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $908
Cash Discount Price: $2,958
vs. Medicare Baseline: 8.50x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Mercy Hospital is $908. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,958. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.50x the Medicare baseline. Located in 401 Nw 42Nd Ave, Plantation, FL.

Cash / Self-Pay

$2,958

Average discount available for prompt cash payment at this facility.

Insurance Median

$908

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: $2,958 (2769%)

Insurance Median: $908 (850%)

Cash: $2,958 (2769% of Medicare)

Ins. Median: $908 (850% 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 850% of the Medicare baseline (a markup of 750%). 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
Freedom Health	$181 - $609	169%
Optimum	$181 - $327	169%
United	$245 - $1,714	229%
Avmed	$253 - $1,904	237%
Simply Healthcare Plans	$274 - $495	257%
Molina	$400 - $1,028	374%
Humana	$442 - $1,295	414%
Health Sun Health Plan	$449 - $811	420%
Aids Healthcare	$464 - $4,570	434%
Mmm Of Fl (Health Advantage Plan)	$485 - $876	454%
United Ppo	$499 - $902	467%
Sunshine State Health Plan	$548 - $990	513%
Aetna	$632 - $1,142	592%
Plotkin Health	$1,054 - $1,904	987%
Prime Health Sherriff	$1,054 - $1,904	987%
Corvel Corporation	$1,129	1057%
Careworks (Rockport)	$1,152	1079%
Prime Health	$1,152	1079%
Medica Healthcare	$1,243 - $2,247	1164%
Multiplan	$1,580 - $3,237	1479%
Evernorth Bh	$1,686 - $3,046	1579%

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 $2,958.
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 Mercy 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.