CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $4,510
Cash Discount Price: $9,054
vs. Medicare Baseline: 42.22x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Fort Walton-Destin Hospital is $4,510. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,054. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 42.22x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.

Cash / Self-Pay

$9,054

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,510

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: $9,054 (8477%)

Insurance Median: $4,510 (4222%)

Cash: $9,054 (8477% of Medicare)

Ins. Median: $4,510 (4222% 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 4222% of the Medicare baseline (a markup of 4122%). 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 - $4,090	229%
Corvel Corporation	$1,046	979%
Prime Health	$1,068	1000%
Careworks (Rockport Community)	$1,101	1031%
Simply	$1,389 - $1,400	1300%
Molina Healthcare	$1,714 - $2,909	1605%
Avmed	$2,165 - $4,545	2027%
Sunshine State Health Plan	$2,300 - $2,318	2153%
Aetna	$2,706 - $2,727	2533%
Humana	$3,427 - $3,454	3209%
Plotkin Health	$4,510 - $4,545	4222%
Prime Health Sheriff	$4,510 - $4,545	4222%
Evolutions Healthcare	$5,862 - $8,181	5488%
Naphcare	$5,862 - $5,908	5488%
Multiplan	$7,035 - $7,726	6586%
Evernorth	$7,215 - $7,272	6755%
Ppo Next	$7,666 - $7,726	7177%
Novanet	$8,117 - $8,181	7599%
Beacon Health Options	$9,019 - $9,090	8444%

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 $9,054.
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 Fort Walton-Destin 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.