CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Hialeah Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $108
  • Cash Discount Price: $1,240
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Hialeah Hospital is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,240. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.01x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$1,240

Average discount available for prompt cash payment at this facility.

Insurance Median
$108

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: $1,240 (1161%)
Insurance Median: $108 (101%)
Cash: $1,240 (1161% of Medicare)
Ins. Median: $108 (101% 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.

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 $37 - $893 35%
Humana $70 - $206 66%
Medicaid / KanCare $70 - $73 66%
UnitedHealthcare $71 - $103 66%
Veterans Administration Mill Bill $72 67%
Medicare (plans) $93 - $225 87%
Avmed Broad Network $102 95%
Devoted Health $103 96%
Leon Health Inc $103 96%
Tricare $104 97%
Bristol Hospice- Miami Dade Llc $105 98%
Catholic Hospice $105 98%
Comprehensive Home Health Care Dba Opuscare Of South Florida $105 98%
Employer Direct Healthcare $105 - $139 98%
Hcr Manor Care Services Of Fl $105 98%
Hospice Other $105 98%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $105 98%
Seasons Hospice And Pallative Care Of Southern Florida Inc $105 98%
Veterans Administration Vaccn $105 98%
Vitas Healthcare Hospice Corporation Of Fl $105 98%
Vitas Hospice Unit Agreement $105 98%
Cigna $108 - $365 101%
Healthsun Health Plans $108 - $115 101%
Longevity Health Plan $109 102%
Dimension Health Wc $110 103%
Workers Compensation $110 103%
Florida Pace Centers $124 116%
Bright Health Management Commercial $126 118%
Self Pay/Uninsured $129 - $136 121%
Imagine Health $142 133%
Naphcare Inc $144 135%
Bc/Bs Of Fl Miami Dade Blue Select $148 139%
Oscar Health Plan Hix $159 149%
Avmed Exchange $183 171%
Bc/Bs Of Fl Health Options Hmo $192 180%
Bc/Bs Of Fl Network Blue $192 180%
Ambetter / Centene $194 182%
Bc/Bs Myblue Hmo Hix $196 184%
Molina Marketplace Program Exchange $199 186%
Bc/Bs Of Fl Ppo $203 190%
Bc/Bs Of Fl Simplyblue $206 193%
Auto Insurance $209 196%
Avmed Select Network $214 200%
Bc/Bs Of Fl Blue Select Exchange Non Par $214 200%
Amerihealth Caritas Next Exchange $225 211%
Bc/Bs Of Fl Phs $643 602%
Dimensions International $806 755%
First Health $843 789%
Dimension Health Ppo $930 871%
Commercial Non-Contracted $1,240 1161%
Self Pay - Mcd Pending 100 Percent $1,240 1161%
Single Case Agreement $1,240 1161%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals