CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $983
Cash Discount Price: $2,985
vs. Medicare Baseline: 9.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at HCA Healthone Presbyterian St Luke's is $983. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,985. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.20x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.

Cash / Self-Pay

$2,985

Average discount available for prompt cash payment at this facility.

Insurance Median

$983

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: $2,985 (2795%)

Insurance Median: $983 (920%)

Cash: $2,985 (2795% of Medicare)

Ins. Median: $983 (920% 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 920% of the Medicare baseline (a markup of 820%). 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
Blue Cross Blue Shield	$65 - $2,465	61%
Pinnacol Workers Comp	$169	158%
Multiplan	$176 - $2,998	165%
United	$185 - $1,499	173%
Rocky Mountain Health Plan	$245	229%
Cigna	$318 - $2,132	298%
Vail Health	$401 - $506	375%
Kaiser	$528 - $866	494%
Aetna	$791 - $1,759	741%
Bright Health	$791 - $999	741%
Emerging Therapy Solutions	$1,266 - $2,132	1185%
Kaiser National Transplant	$1,266 - $1,599	1185%
Colorado Program For Children With Special Needs	$1,345 - $1,699	1259%
Western Plains Community Health	$1,715 - $2,165	1606%
Northcare	$1,847 - $2,332	1729%
Physician Health Partners	$1,847 - $2,332	1729%
Medical Development International	$2,110 - $2,665	1975%
Prime Health	$2,374 - $2,998	2223%

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 $2,985.
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 HCA Healthone Presbyterian St Luke's 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.