CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Grossmont Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $677
Cash Discount Price: $1,016
vs. Medicare Baseline: 6.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Grossmont Hospital is $677. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,016. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.34x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$1,016

Average discount available for prompt cash payment at this facility.

Insurance Median

$677

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: $1,016 (951%)

Insurance Median: $677 (634%)

Cash: $1,016 (951% of Medicare)

Ins. Median: $677 (634% 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 634% of the Medicare baseline (a markup of 534%). 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
Aetna	$22 - $846	21%
Health Net	$86 - $1,083	81%
Molina	$190 - $535	178%
Blue Cross Blue Shield	$203 - $1,043	190%
Cigna	$203 - $948	190%
Community Health Group	$203 - $921	190%
UnitedHealthcare	$215 - $1,110	201%
Managed Health Network	$460	431%
Blue Shield	$677 - $1,043	634%
County Medical Services	$812 - $914	760%
Allianz Global Assistance	$887	830%
Medi-Cal	$948	888%
Medicare (plans)	$948	888%
Humana	$1,083	1014%
San Diego Pace	$1,110	1039%

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 $1,016.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 76536.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Grossmont Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 76536.
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.