CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: HCA Florida South Shore Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,190
Cash Discount Price: $4,759
vs. Medicare Baseline: 11.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at HCA Florida South Shore Hospital is $1,190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,759. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.14x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.

Cash / Self-Pay

$4,759

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,190

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: $4,759 (4456%)

Insurance Median: $1,190 (1114%)

Cash: $4,759 (4456% of Medicare)

Ins. Median: $1,190 (1114% 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 1114% of the Medicare baseline (a markup of 1014%). 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	$223 - $225	209%
United	$245 - $2,152	229%
Access 2 Healthcare Physicians Freedom Health	$341 - $344	319%
Access 2 Healthcare Physicians Optimum	$341 - $344	319%
Freedom Health Care	$369 - $373	345%
Optimum Healthcare	$369 - $373	345%
Avmed	$379 - $1,195	355%
Simply Healthcare	$729 - $736	683%
Molina	$900 - $1,291	843%
Corvel Corporation	$937	877%
Rockport Healthcare Group	$937	877%
Prime Health	$956	895%
Sunshine State Health Plan	$1,208 - $1,219	1131%
Humana	$1,326 - $1,339	1241%
Aetna	$1,421 - $1,435	1330%
Plotkin Health	$2,368 - $2,391	2217%
Prime Health Sheriff	$2,368 - $2,391	2217%
Evolutions Healthcare Systems	$2,605 - $4,399	2439%
Multiplan	$3,552 - $4,065	3326%

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 $4,759.
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 South Shore 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.