CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fishermen's Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $625
Cash Discount Price: $718
vs. Medicare Baseline: 5.85x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fishermen's Community Hospital is $625. 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 5.85x the Medicare baseline. Located in 3301 Overseas Hwy, Marathon, FL.

Cash / Self-Pay

$718

Average discount available for prompt cash payment at this facility.

Insurance Median

$625

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: $625 (585%)

Cash: $718 (672% of Medicare)

Ins. Median: $625 (585% 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 585% of the Medicare baseline (a markup of 485%). 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
Amerigroup	$67	63%
Medicaid / KanCare	$67 - $74	63%
UnitedHealthcare	$67 - $1,105	63%
Wellcare	$70	66%
Sunshine State	$71	66%
Aetna	$72 - $846	67%
Vista	$72	67%
Blue Cross Blue Shield	$185 - $1,105	173%
Leon Medical	$232	217%
Medica Health Plan	$232	217%
Medicare (plans)	$232 - $313	217%
Humana	$253	237%
Avmed	$255 - $915	239%
Cigna	$265 - $884	248%
Non Contracted	$406	380%
International	$718	672%
Amerihealth	$829	776%
Dimension Health Plan	$829 - $994	776%
Affordable	$994	931%
Phcs	$994	931%
Quality Health	$994	931%

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 $718.
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 Fishermen's Community 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.