CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Adventist Health Castle

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $109
Cash Discount Price: $123
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Adventist Health Castle is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.02x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $123 (115%)

Insurance Median: $109 (102%)

Cash: $123 (115% of Medicare)

Ins. Median: $109 (102% 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.

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
Alohacare Quest Mcaid - All Other Plans	$27 - $169	25%
Kfh Mcr Adv	$27 - $124	25%
Medicare (plans)	$27 - $124	25%
UnitedHealthcare	$27 - $47	25%
Alohacare Mcr Adv Profee Only	$28	26%
Devoted Hlth Mcr Adv - All Plans	$28 - $130	26%
Pacific Admin Ppo - All Plans	$29 - $429	27%
Health Alliance - All Plans	$39 - $540	37%
Multiplan Hmn - All Plans	$39 - $171	37%
State Of Hi Nonprofit - All Plans	$61 - $1,181	57%
First Health Ppo - All Plans	$87 - $634	81%
Hwmg/Hmaa - All Plans	$93 - $497	87%
Medicaid / KanCare	$93 - $675	87%
Ohana Health Plan - All Plans	$93 - $126	87%
Hmsa Hmo	$109	102%
Hmsa Ppo - All Other Plans	$109	102%
Mdx Hawaii Ppo - All Plans	$160 - $539	150%
Kfh - All Other Plans	$574	537%
Uni Health Alliance - All Plans	$630	590%

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 $123.
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 Adventist Health Castle 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.