CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Grandview Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $1,197
  • Cash Discount Price: $544
  • vs. Medicare Baseline: 11.21x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Grandview Medical Center is $1,197. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $544. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.21x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$544

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,197

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: $544 (509%)
Insurance Median: $1,197 (1121%)
Cash: $544 (509% of Medicare)
Ins. Median: $1,197 (1121% 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 1121% of the Medicare baseline (a markup of 1021%). 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
Medicaid / KanCare $28 26%
Encompass Health $79 74%
Tricare $91 85%
Veterans Eval Services $92 86%
Blue Advantage $94 88%
Humana $94 88%
Medicare (plans) $94 88%
UnitedHealthcare $94 - $1,337 88%
Victory Health $94 88%
Viva Health $94 - $1,635 88%
Select Health $95 89%
Cigna $96 - $170 90%
Hospice $96 90%
Node Champva $96 90%
Node Devoted Health Mcr Adv $96 90%
Node Va $96 90%
Aetna $97 - $826 91%
Node Clover Health Mcr Adv $97 91%
Node Wellcare Mcr Adv $98 92%
Node Us Dept Of Labor $120 112%
Ambetter / Centene $143 134%
Healthspring $167 156%
Blue Cross Blue Shield $191 179%
Self Pay $402 - $713 376%
Bp Health Advocate $670 - $743 627%
Ag Administrators $937 - $1,040 877%
Alamed $937 - $1,040 877%
Choicecare $937 - $1,040 877%
Drummond $937 - $1,040 877%
American Employee Alliance $1,071 - $1,189 1003%
Healthchoice $1,339 - $1,783 1254%
Value Options $1,339 - $1,486 1254%
First Health $1,607 - $2,324 1505%
Multiplan $1,634 - $2,080 1530%
Blue Bell Creameries $1,875 - $2,080 1755%
Natl Comp Care $2,008 - $2,229 1880%
Usa Ppo $2,008 - $2,229 1880%
Coventry Work Comp Al $2,094 - $2,324 1960%
Novanet $2,162 - $2,400 2024%
Alabama Wc $2,276 - $2,526 2131%
Cal-Med $2,276 - $2,526 2131%
Corvel $2,276 - $2,526 2131%
Associated Admin $2,410 - $2,675 2256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals