CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fairview Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $256
  • Cash Discount Price: $398
  • vs. Medicare Baseline: 2.40x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fairview Hospital is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $398. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.40x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$398

Average discount available for prompt cash payment at this facility.

Insurance Median
$256

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: $398 (373%)
Insurance Median: $256 (240%)
Cash: $398 (373% of Medicare)
Ins. Median: $256 (240% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 240% of the Medicare baseline (a markup of 140%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Capital District Physicians' Health Plan $16 - $395 15%
Medicaid / KanCare $16 - $256 15%
Commcare Alliance $29 - $160 27%
Blue Cross Blue Shield $30 - $373 28%
Fallon $30 - $193 28%
Health New England $30 - $320 28%
Hospice $30 - $164 28%
Medicare (plans) $30 - $161 28%
Other Government $30 - $165 28%
Aetna $93 - $331 87%
Workers Comp $93 - $280 87%
Point32Health $97 - $417 91%
Bmchnp $101 - $266 95%
UnitedHealthcare $113 - $377 106%
Comm Fallon Qhp $167 - $270 156%
Comm Hne Hmo $213 - $303 199%
Allways Nhp $217 - $284 203%
Unicare $218 - $285 204%
Comm Hne Ppo $226 - $322 212%
Cigna $302 - $408 283%
Mvp $302 - $395 283%
Oxford $302 - $395 283%
First Health $312 - $417 292%
Connecticare $319 - $417 299%
Consolidated Health Plans $319 - $417 299%
Other Commercial $319 - $417 299%
Phcs $319 - $417 299%
Self Pay $319 - $417 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals