CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Pali Momi Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $172
Cash Discount Price: $381
vs. Medicare Baseline: 1.61x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Pali Momi Medical Center is $172. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $381. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.61x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$381

Average discount available for prompt cash payment at this facility.

Insurance Median

$172

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: $381 (357%)

Insurance Median: $172 (161%)

Cash: $381 (357% of Medicare)

Ins. Median: $172 (161% 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
UnitedHealthcare	$47 - $145	44%
Hmsa	$51 - $126	48%
Alohacare	$76 - $162	71%
Ohana	$78 - $172	73%
Mdx	$124 - $465	116%
Devoted	$132	124%
Pac Admin	$155 - $407	145%
Uha	$165	154%
Hwmg/Hmaa	$218 - $438	204%
Verdegard	$307 - $465	287%
Calvos	$436 - $517	408%
Mimoh	$436 - $517	408%
Hcha	$465 - $551	435%
Kaiser	$465 - $551	435%
Multiplan	$465 - $586	435%
Coventry	$494 - $586	463%
Mccp	$494 - $586	463%

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 $381.
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 Pali Momi Medical Center 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.