CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Daviess Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $122
Cash Discount Price: $298
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Daviess Community Hospital is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.14x the Medicare baseline. Located in 1314 E Walnut St, Washington, IN.

Cash / Self-Pay

$298

Average discount available for prompt cash payment at this facility.

Insurance Median

$122

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: $298 (279%)

Insurance Median: $122 (114%)

Cash: $298 (279% of Medicare)

Ins. Median: $122 (114% 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	$25 - $796	23%
Blue Cross Blue Shield	$25 - $632	23%
Encore Ppo-All Plans	$25 - $225	23%
Humana	$25 - $146	23%
UnitedHealthcare	$25 - $668	23%
Patoka Valley-All Plans	$27 - $398	25%
St. Vincent Health - All Plans	$28 - $517	26%
Mdwise Marketplace-All Plans	$49 - $208	46%
Siho-All Plans	$49 - $716	46%
Sagamore Valley-All Plans	$53 - $772	50%
Caresource Mcaid-All Plans	$54 - $66	51%
Hoosier Healthwise Mcaid-All Plans	$54 - $66	51%

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 $298.
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 Daviess 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.