CMS Price Transparency Data

Ultrasound, pelvis

Facility: HCA Florida Lawnwood Hospital

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $1,179
  • Cash Discount Price: $4,607
  • vs. Medicare Baseline: 11.04x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at HCA Florida Lawnwood Hospital is $1,179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,607. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.04x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$4,607

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,179

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: $4,607 (4313%)
Insurance Median: $1,179 (1104%)
Cash: $4,607 (4313% of Medicare)
Ins. Median: $1,179 (1104% 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 1104% of the Medicare baseline (a markup of 1004%). 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
Blue Cross Blue Shield $80 - $4,402 75%
Pinnacol Workers Comp $169 158%
Multiplan $176 - $5,353 165%
United $185 - $2,677 173%
Rocky Mountain Health Plan $245 229%
Cigna $268 - $3,807 251%
Vail Health $271 - $904 254%
Freedom Health $286 - $532 268%
Optimum $286 268%
Kaiser $357 - $2,112 334%
Avmed $432 - $1,661 404%
Simply Healthcare Plans $432 404%
Bright Health $535 - $1,784 501%
Molina $631 - $897 591%
Health Sun Health Plan $708 663%
Sunshine State Health Plan $847 793%
Aetna $942 - $3,141 882%
Corvel Corporation $1,078 1009%
Careworks (Rockport) $1,101 1031%
Prime Health $1,101 - $5,353 1031%
Western Plains Community Health $1,160 - $3,866 1086%
Office Of Sheiff Highland Co $1,163 1089%
Humana $1,229 - $1,329 1151%
Northcare $1,249 - $4,164 1169%
Physician Health Partners $1,249 - $4,164 1169%
Medical Development International $1,428 - $4,759 1337%
United Ppo $1,462 1369%
Plotkin Health $1,661 1555%
Prime Health Sherriff $1,661 1555%
Evernorth Bh $2,658 2489%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals