CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Adventist Health Tulare

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $123
Cash Discount Price: $139
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Adventist Health Tulare is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$139

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $139 (130%)

Insurance Median: $123 (115%)

Cash: $139 (130% of Medicare)

Ins. Median: $123 (115% 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.

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
Blue Shield Mcare	$27 - $134	25%
Fhcn Pace Mcr Adv - All Plans	$27 - $134	25%
Medicare (plans)	$27 - $134	25%
Tricare	$27 - $134	25%
UnitedHealthcare	$27 - $986	25%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$27	25%
Ah Employee Health Plan - All Plans	$30 - $242	28%
Incentive Hlth - All Plans	$30 - $242	28%
Blue Shield Epn	$34 - $430	32%
Hs Interplan-All Plans	$34 - $913	32%
Cal Forensic Med Grp - All Plans	$35 - $175	33%
Cigna	$35 - $631	33%
Blue Shield-All Other Plans	$36 - $595	34%
Healthnet Hmo/Ppo - All Other Plans	$39 - $358	37%
Blue Cross Blue Shield	$40 - $415	37%
Ccipa Medi-Cal - All Plans	$60 - $111	56%
Healthnet Medi-Cal	$60 - $112	56%
Medi-Cal	$60 - $86	56%
Upn-United Physcn Ntwrk Mcal Profee Only	$60	56%
Aetna	$83 - $518	78%
Dignity Mcal Op Only	$94	88%
Independence Op Only - All Plans	$94	88%
Dignity Mcr Op Only - All Other Plans	$134	125%
Prime Health - All Plans	$134	125%
Prison Hlthcre - All Plans	$172	161%
Bright Health - All Plans	$195	183%
Western Growers - All Plans	$627	587%
Network By Design-All Plans	$953	892%
Multiplan - All Plans	$1,158	1084%

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 $139.
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 Adventist Health Tulare 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.