CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Appling Healthcare

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $300
Cash Discount Price: $360
vs. Medicare Baseline: 2.81x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Appling Healthcare is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.81x the Medicare baseline. Located in 163 E Tollison Street, Baxley, GA.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$300

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: $360 (337%)

Insurance Median: $300 (281%)

Cash: $360 (337% of Medicare)

Ins. Median: $300 (281% 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 281% of the Medicare baseline (a markup of 181%). 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
Aetna	$98 - $288	92%
Cigna	$98 - $419	92%
UnitedHealthcare	$98 - $408	92%
Medicare (plans)	$127	119%
Blue Cross Blue Shield	$312	292%
Beech Street	$384	360%

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 $360.
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 Appling Healthcare 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.