CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: West Kendall Baptist Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $420
  • Cash Discount Price: $718
  • vs. Medicare Baseline: 3.93x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at West Kendall Baptist Hospital is $420. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $718. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.93x the Medicare baseline. Located in 9555 Sw 162 Ave, Miami, FL.
Cash / Self-Pay
$718

Average discount available for prompt cash payment at this facility.

Insurance Median
$420

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: $718 (672%)
Insurance Median: $420 (393%)
Cash: $718 (672% of Medicare)
Ins. Median: $420 (393% 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 393% of the Medicare baseline (a markup of 293%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Amerigroup $67 63%
Medicaid / KanCare $67 - $74 63%
UnitedHealthcare $70 - $1,105 66%
Wellcare $70 66%
Sunshine State $71 66%
Aetna $72 - $884 67%
Vista $72 67%
Medicare (plans) $109 - $147 102%
Blue Cross Blue Shield $113 - $716 106%
Medica Health Plan $117 110%
Humana $119 111%
Avmed $120 - $538 112%
Leon Medical $122 114%
Cigna $124 - $884 116%
Non Contracted $406 380%
Amerihealth $497 465%
International $718 672%
Dimension Health Plan $829 - $994 776%
Affordable $994 931%
Phcs $994 931%
Quality Health $994 931%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9555 Sw 162 Ave, Miami, FL 33196
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals