CMS Price Transparency Data

Ultrasound, pelvis

Facility: Larkin Community Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $107
  • Cash Discount Price: $582
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Larkin Community Hospital is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $582. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 7031 Sw 62Nd Ave, South Miami, FL.
Cash / Self-Pay
$582

Average discount available for prompt cash payment at this facility.

Insurance Median
$107

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: $582 (545%)
Insurance Median: $107 (100%)
Cash: $582 (545% of Medicare)
Ins. Median: $107 (100% 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.

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
Medicare (plans) $23 - $1,693 22%
Jipa Network-All Plans $32 30%
Aetna $33 - $1,612 31%
Fci-All Plans $33 - $123 31%
Global Excel-All Plans $33 - $967 31%
Clear Springs Hlth-All Plans $35 - $112 33%
Medicaid / KanCare $35 - $111 33%
Fdc-All Plans $38 36%
UnitedHealthcare $41 - $144 38%
Avmed-All Plans $50 - $1,612 47%
Bright Health-All Other Plans $50 - $1,934 47%
Coventry Comml-All Plans $50 - $1,612 47%
Corvel Mcaid Workers Comp $95 89%
Sunshine Behavioral $95 89%
Blue Cross Blue Shield $101 - $804 95%
Ambetter / Centene $105 98%
Community Care Phks Mcaid-All Other Plans $105 98%
Florida Comm Care Mcaid $105 98%
Humana $105 - $1,612 98%
Magellan Complete Care $105 98%
Molina Exch Marketplace-All Other Plans $105 98%
Florida Comm Care Mcare-All Other Plans $107 100%
Ops Maritime-All Plans $107 100%
Opus Hospice Ip Only-All Plans $107 100%
Preferred Care Partners Mcare-All Plans $107 100%
Unicare Simply Mcare Ppo-All Plans $112 105%
Wellpath-All Plans $117 110%
Allianz (Azga)-All Plans $139 130%
Cigna $400 374%
Healthsun-All Plans $484 453%
Star Network-All Plans $645 604%
Jmh Health Plan Hmo/Ppo-All Other Plans $887 830%
Haa Preferred Partners-All Plans $967 905%
Corvel Mcare Workers Comp-All Plans $1,451 1358%
Careplus Health-All Other Plans $1,612 1509%
Centurion-All Plans $1,612 1509%
Doctors Healthcare-All Plans $1,612 1509%
First Med Hp Of Fl-All Plans $1,612 1509%
Florida Health Solution/Hmo-All Plans $1,612 1509%
Oscar Health-All Plans $3,224 3018%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7031 Sw 62Nd Ave, South Miami, FL 33143
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals