CMS Price Transparency Data

Ultrasound, pelvis

Facility: Physicians Regional Medical Center - Pine Ridge

Billing Code: 76856 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76856
  • Insurance Median: $121
  • Cash Discount Price: $815
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Ultrasound, pelvis at Physicians Regional Medical Center - Pine Ridge is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $815. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.13x the Medicare baseline. Located in 6101 Pine Ridge Road, Naples, FL.
Cash / Self-Pay
$815

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $815 (763%)
Insurance Median: $121 (113%)
Cash: $815 (763% of Medicare)
Ins. Median: $121 (113% 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.

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
Veterans Eval Services $101 95%
Tricare $104 97%
Childrens Medical Services $105 98%
Medicaid / KanCare $105 - $116 98%
UnitedHealthcare $105 - $876 98%
Aetna $107 - $2,404 100%
Blue Cross Blue Shield $107 - $821 100%
Humana $107 - $108 100%
Medicare (plans) $107 100%
Node Champva $109 102%
Node Non Par Hospice Agree $109 102%
Node Va $109 102%
Freedom Optimum $111 104%
Integral Health $111 104%
Occunet $111 - $273 104%
Wellcare $111 104%
Node Wellcare Mcr Adv $112 105%
Simply Healthcare Plan $112 105%
Magellan $113 106%
Amerigroup $115 108%
Prime Health Work Comp Fl $119 111%
Rockport $119 111%
Prestige Health $122 114%
Florida Workers Compensation $123 115%
Node Us Dept Of Labor $136 127%
Florida State Auto Insurance $218 204%
Ambetter / Centene $278 260%
Cigna $392 367%
Community Health Partners $562 526%
Self Pay $652 - $869 610%
Simply Healthcare $1,122 1050%
Avmed $1,376 1288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6101 Pine Ridge Road, Naples, FL 34119
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals