CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida St Petersburg Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,045
Cash Discount Price: $4,036
vs. Medicare Baseline: 9.78x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida St Petersburg Hospital is $1,045. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,036. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.78x the Medicare baseline. Located in 6500 38Th Ave N, Saint Petersburg, FL.

Cash / Self-Pay

$4,036

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,045

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: $4,036 (3779%)

Insurance Median: $1,045 (978%)

Cash: $4,036 (3779% of Medicare)

Ins. Median: $1,045 (978% 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 978% of the Medicare baseline (a markup of 878%). 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	$175 - $204	164%
United	$245 - $1,954	229%
Access 2 Healthcare Physicians Freedom Health	$269 - $313	252%
Access 2 Healthcare Physicians Optimum	$269 - $313	252%
Freedom Health Care	$291 - $339	272%
Optimum Healthcare	$291 - $339	272%
Avmed	$298 - $1,086	279%
Simply Healthcare	$574 - $669	537%
Molina	$709 - $1,172	664%
Sunshine State Health Plan	$951 - $1,107	890%
Humana	$1,045 - $1,216	978%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Aetna	$1,119 - $1,303	1048%
Evolutions Healthcare Systems	$1,865 - $3,995	1746%
Plotkin Health	$1,865 - $2,171	1746%
Prime Health Sheriff	$1,865 - $2,171	1746%
Multiplan	$2,798 - $3,691	2620%

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 $4,036.
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 St Petersburg 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.