CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Trinity Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,608
Cash Discount Price: $6,433
vs. Medicare Baseline: 15.05x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Trinity Hospital is $1,608. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,433. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.05x the Medicare baseline. Located in 9330 Sr 54, Trinity, FL.

Cash / Self-Pay

$6,433

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,608

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: $6,433 (6023%)

Insurance Median: $1,608 (1505%)

Cash: $6,433 (6023% of Medicare)

Ins. Median: $1,608 (1505% 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 1505% of the Medicare baseline (a markup of 1405%). 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 - $2,895	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$302	283%
Access 2 Healthcare Physicians Freedom Health	$463	433%
Access 2 Healthcare Physicians Optimum	$463	433%
Freedom Health Care	$502	470%
Optimum Healthcare	$502	470%
Avmed	$515 - $1,608	482%
Simply Healthcare	$991	928%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Molina	$1,222 - $1,737	1144%
Sunshine State Health Plan	$1,640	1535%
Humana	$1,801	1686%
Aetna	$1,930	1807%
Beacon Health Options	$3,217	3012%
Plotkin Health	$3,217	3012%
Prime Health Sheriff	$3,217	3012%
Evolutions Healthcare Systems	$3,860 - $5,918	3614%
Multiplan	$4,825 - $5,468	4517%
Evernorth	$5,146	4818%

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 $6,433.
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 Trinity 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.