CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Fawcett Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,168
Cash Discount Price: $4,673
vs. Medicare Baseline: 10.94x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Fawcett Hospital is $1,168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,673. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.94x the Medicare baseline. Located in 21298 Olean Blvd, Port Charlotte, FL.

Cash / Self-Pay

$4,673

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,168

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: $4,673 (4375%)

Insurance Median: $1,168 (1094%)

Cash: $4,673 (4375% of Medicare)

Ins. Median: $1,168 (1094% 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 1094% of the Medicare baseline (a markup of 994%). 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	$220	206%
United	$245 - $2,103	229%
Access 2 Healthcare Physicians Freedom Health	$336	315%
Access 2 Healthcare Physicians Optimum	$336	315%
Freedom Health Care	$364	341%
Optimum Healthcare	$364	341%
Avmed	$374 - $1,168	350%
Simply Healthcare	$720	674%
Molina	$888 - $1,262	831%
Corvel Corporation	$1,018	953%
Rockport Healthcare Group	$1,018	953%
Prime Health	$1,040	974%
Sunshine State Health Plan	$1,192	1116%
Humana	$1,308	1225%
Aetna	$1,402	1313%
Behealthy America	$1,822	1706%
Evolutions Healthcare Systems	$2,336 - $4,299	2187%
Healthcare Sarasota	$2,336	2187%
Plotkin Health	$2,336	2187%
Prime Health Sheriff	$2,336	2187%
Multiplan	$3,505 - $3,972	3282%

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 $4,673.
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 Fawcett 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.