CMS Price Transparency Data

Ultrasound, pelvis

Facility: Marion Communtiy Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,689
  • Cash Discount Price: $6,057
  • vs. Medicare Baseline: 15.81x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Marion Communtiy Hospital is $1,689. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,057. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.81x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$6,057

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,689

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: $6,057 (5671%)
Insurance Median: $1,689 (1581%)
Cash: $6,057 (5671% of Medicare)
Ins. Median: $1,689 (1581% 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 1581% of the Medicare baseline (a markup of 1481%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
United $245 - $2,744 229%
Avmed $673 - $1,707 630%
Simply $864 - $939 809%
Corvel Corporation $987 924%
Prime Health $1,008 944%
Careworks (Rockport Community) $1,039 973%
Marion County Schools $1,039 973%
Molina Healthcare $1,066 - $1,951 998%
Humana $1,122 - $1,220 1050%
Sunshine State Health Plan $1,430 - $1,555 1339%
Aetna $1,683 - $1,829 1576%
Plotkin Health $2,804 - $3,049 2625%
Prime Health Sheriff $2,804 - $3,049 2625%
Multiplan $4,375 - $4,756 4096%
Ppo Next $4,767 - $5,183 4463%
Novanet $5,048 - $5,488 4726%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals