CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UW Health

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $104
Cash Discount Price: $82
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UW Health is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $82 (77%)

Insurance Median: $104 (97%)

Cash: $82 (77% of Medicare)

Ins. Median: $104 (97% 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
Aetna	$43 - $878	40%
Blue Cross Blue Shield	$43 - $602	40%
Humana	$43 - $107	40%
Medicare (plans)	$43 - $117	40%
Mychoice Wi Medical Adv	$43 - $107	40%
UnitedHealthcare	$43 - $935	40%
Medicaid / KanCare	$71	66%
Quartz Aso	$128 - $664	120%
Quartz Fully Insured	$128 - $422	120%
Hfn	$137 - $958	128%
Ecoh	$153 - $958	143%
Cigna	$172 - $971	161%
Alliance Premier Network	$229 - $664	214%
The Alliance	$249 - $855	233%
Wps	$257	241%
Beloit Healt System	$299 - $1,098	280%
Mercy Care	$360	337%
Workers Comp	$360	337%
Wps Ppo	$941	881%
Mercycare	$1,136	1064%
First Health/Coventry	$1,196	1120%
Health Payment Systems	$1,420	1329%
Healthsmart	$1,420	1329%
Sheboygan Employers Health Network	$1,514	1417%
Multiplan	$1,692	1584%

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 $82.
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 UW Health 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.