CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UMass Memorial Healthalliance Hospitals

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $195
Cash Discount Price: $566
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UMass Memorial Healthalliance Hospitals is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $566. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.83x the Medicare baseline. Located in 60 Hospital Road, Leominster, MA.

Cash / Self-Pay

$566

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $566 (530%)

Insurance Median: $195 (183%)

Cash: $566 (530% of Medicare)

Ins. Median: $195 (183% 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
Workers Compensation [20501]	$93	87%
Champva [11001]	$114	107%
Cigna	$127 - $601	119%
Correctional Care [11003]	$127	119%
Institution [10406]	$127 - $300	119%
Medicaid / KanCare	$127 - $294	119%
Medicare (plans)	$127	119%
Tufts Dual [10111]	$127	119%
Tufts Us Family [11203]	$127	119%
Blue Cross Blue Shield	$131 - $207	123%
Aetna	$133 - $370	125%
Commonwealth Care Mcr [10115]	$133	125%
Fallon Mcr Supp [20202]	$133	125%
Harvard Pilgrim Mcr [10106]	$133	125%
Mgb Mcr [10124]	$133	125%
Tufts Mcr [10112]	$133	125%
UnitedHealthcare	$133 - $566	125%
Senior Whole Health [10110]	$136	127%
Wellpoint [11112]	$198	185%
Tufts Connectorcare [10507]	$216	202%
Tufts [11201]	$282	264%
Hsno/Free Care [10801]	$294	275%
Hne [11108]	$316	296%
Fallon Connectorcare [10503]	$406	380%
First Health Network [11120]	$424	397%
Multiplan [11109]	$424	397%
Connecticare [11105]	$566	530%
Fallon Carelon Hlth [28]	$566	530%
Fallon Mcaid Carelon Hlth [29]	$566	530%
Grants [20507]	$566	530%

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 $566.
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 UMass Memorial Healthalliance Hospitals 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.