CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: HCA Florida Citrus Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,297
Cash Discount Price: $5,136
vs. Medicare Baseline: 12.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at HCA Florida Citrus Hospital is $1,297. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,136. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.14x the Medicare baseline. Located in 502 W Highland Blvd, Inverness, FL.

Cash / Self-Pay

$5,136

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,297

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: $5,136 (4809%)

Insurance Median: $1,297 (1214%)

Cash: $5,136 (4809% of Medicare)

Ins. Median: $1,297 (1214% 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 1214% of the Medicare baseline (a markup of 1114%). 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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$241	226%
United	$245 - $2,311	229%
Access 2 Healthcare Physicians Freedom Health	$308	288%
Access 2 Healthcare Physicians Optimum	$308	288%
Freedom Health Care	$334	313%
Optimum Healthcare	$334	313%
Avmed	$411 - $1,284	385%
Corvel Corporation	$872	816%
Rockport Healthcare Group	$872	816%
Prime Health	$890	833%
Molina	$976 - $1,387	914%
Sunshine State Health Plan	$1,310	1226%
Humana	$1,438	1346%
Aetna	$1,541	1443%
Beacon Health Options	$2,568	2404%
Plotkin Health	$2,568	2404%
Prime Health Sheriff	$2,568	2404%
Evolutions Healthcare Systems	$3,082 - $4,725	2885%
Multiplan	$3,852 - $4,366	3606%
Evernorth	$4,109	3847%

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 $5,136.
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 Florida Citrus 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.