CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: T J Samson Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $102
Cash Discount Price: $95
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at T J Samson Community Hospital is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $95. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.95x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$95

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $95 (89%)

Insurance Median: $102 (95%)

Cash: $95 (89% of Medicare)

Ins. Median: $102 (95% 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
Blue Cross Blue Shield	$26 - $536	24%
Center Care Select - All Plans	$26 - $536	24%
Molina Mcr Adv	$26 - $108	24%
Signature Health - All Plans	$26 - $107	24%
Wellcare Mcr Adv - All Other Plans	$26 - $106	24%
Devoted Mcr Adv - All Plans	$27 - $112	25%
Humana	$27 - $106	25%
Caresource - All Plans	$33 - $159	31%
Molina Marketplace - All Other Plans	$33 - $159	31%
Aetna	$63 - $100	59%
Molina Mcaid	$65 - $103	61%
Wellcare Mcaid	$68 - $104	64%
UnitedHealthcare	$150 - $490	140%
Phcs/Multiplan - All Plans	$181 - $592	169%
First Health - All Plans	$183 - $598	171%

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 $95.
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 T J Samson 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.