CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Brandon Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76856
Insurance Median: $2,129
Cash Discount Price: $8,515
vs. Medicare Baseline: 19.93x Medicare

The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Brandon Hospital is $2,129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,515. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 19.93x the Medicare baseline. Located in 119 Oakfield Dr, Brandon, FL.

Cash / Self-Pay

$8,515

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,129

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: $8,515 (7972%)

Insurance Median: $2,129 (1993%)

Cash: $8,515 (7972% of Medicare)

Ins. Median: $2,129 (1993% 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 1993% of the Medicare baseline (a markup of 1893%). 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 - $3,832	229%
Access 2 Healthcare Physicians Freedom Optimum Group Members	$400	374%
Access 2 Healthcare Physicians Freedom Health	$613	574%
Access 2 Healthcare Physicians Optimum	$613	574%
Freedom Health Care	$664	622%
Optimum Healthcare	$664	622%
Avmed	$681 - $2,129	638%
Corvel Corporation	$1,051	984%
Rockport Healthcare Group	$1,051	984%
Prime Health	$1,073	1005%
Simply Healthcare	$1,311	1227%
Molina	$1,618 - $2,299	1515%
Sunshine State Health Plan	$2,171	2033%
Humana	$2,384	2232%
Aetna	$2,555	2392%
Beacon Health Options	$4,258	3987%
Plotkin Health	$4,258	3987%
Prime Health Sheriff	$4,258	3987%
Evolutions Healthcare Systems	$5,109 - $7,834	4783%
Multiplan	$6,386 - $7,238	5979%
Evernorth	$6,812	6378%

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 $8,515.
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 Brandon 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.