CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: HCA Florida North Florida Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,089
Cash Discount Price: $3,105
vs. Medicare Baseline: 10.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at HCA Florida North Florida Hospital is $1,089. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,105. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.20x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.

Cash / Self-Pay

$3,105

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,089

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: $3,105 (2907%)

Insurance Median: $1,089 (1020%)

Cash: $3,105 (2907% of Medicare)

Ins. Median: $1,089 (1020% 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 1020% of the Medicare baseline (a markup of 920%). 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
Avmed	$193 - $2,303	181%
United	$241 - $2,072	226%
Simply	$247 - $709	231%
Molina Healthcare	$305 - $1,474	286%
Humana	$321 - $921	301%
Sunshine State Health Plan	$409 - $1,174	383%
Aetna	$481 - $1,382	450%
Plotkin Health	$802 - $2,303	751%
Prime Health Sheriff	$802 - $2,303	751%
Corizon Phs	$963 - $2,763	902%
Corvel Corporation	$975	913%
Prime Health	$995	932%
Careworks (Rockport Community)	$1,026	961%
Multiplan	$1,252 - $3,914	1172%
Evernorth	$1,284 - $3,684	1202%
Evolutions Healthcare	$1,364 - $3,914	1277%
Ppo Next	$1,364 - $3,914	1277%
Novanet	$1,444 - $4,145	1352%
Beacon Health Options	$1,605 - $4,605	1503%

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 $3,105.
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 North Florida 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.