CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Northside Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $1,012
Cash Discount Price: $3,750
vs. Medicare Baseline: 9.47x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Northside Hospital is $1,012. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,750. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.47x the Medicare baseline. Located in 6000 49Th St N, Saint Petersburg, FL.

Cash / Self-Pay

$3,750

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,012

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: $3,750 (3511%)

Insurance Median: $1,012 (947%)

Cash: $3,750 (3511% of Medicare)

Ins. Median: $1,012 (947% 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 947% of the Medicare baseline (a markup of 847%). 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	$176	165%
United	$245 - $1,687	229%
Access 2 Healthcare Physicians Freedom Health	$270	253%
Access 2 Healthcare Physicians Optimum	$270	253%
Freedom Health Care	$292	273%
Optimum Healthcare	$292	273%
Avmed	$300 - $937	281%
Simply Healthcare	$577	540%
Molina	$712 - $1,012	667%
Sunshine State Health Plan	$956	895%
Humana	$1,050	983%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Aetna	$1,125	1053%
Plotkin Health	$1,875	1755%
Prime Health Sheriff	$1,875	1755%
Evolutions Healthcare Systems	$2,062 - $3,450	1931%
Multiplan	$2,812 - $3,187	2633%

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 $3,750.
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 Northside 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.