CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: HCA Florida Orange Park Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,950
Cash Discount Price: $4,790
vs. Medicare Baseline: 18.26x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at HCA Florida Orange Park Hospital is $1,950. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,790. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.26x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.

Cash / Self-Pay

$4,790

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,950

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: $4,790 (4485%)

Insurance Median: $1,950 (1826%)

Cash: $4,790 (4485% of Medicare)

Ins. Median: $1,950 (1826% 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 1826% of the Medicare baseline (a markup of 1726%). 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
United	$245 - $2,171	229%
Optimum Healthcare	$399 - $405	374%
Avmed	$571 - $1,351	535%
Simply Healthcare	$732 - $743	685%
Corvel Corporation	$923	864%
Prime Health	$942	882%
Positive Healthcare	$1,046 - $1,061	979%
Sunshine State Health Plan	$1,213 - $1,230	1136%
Molina Healthcare	$1,284 - $1,303	1202%
Aetna	$1,427 - $1,447	1336%
Humana	$1,950 - $1,978	1826%
Medicare (plans)	$2,140 - $2,171	2004%
Plotkin Health	$2,378 - $2,412	2226%
Multiplan	$3,709 - $4,101	3473%
Evernorth	$3,804 - $3,859	3561%
Evolutions Healthcare	$3,804 - $4,101	3561%
Ppo Next	$4,042 - $4,101	3784%
Novanet	$4,280 - $4,342	4007%

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 $4,790.
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 Orange Park 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.