CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Boston Children's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $763
Cash Discount Price: $1,074
vs. Medicare Baseline: 7.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Boston Children's Hospital is $763. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,074. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.14x the Medicare baseline. Located in 300 Longwood Avenue, Boston, MA.

Cash / Self-Pay

$1,074

Average discount available for prompt cash payment at this facility.

Insurance Median

$763

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: $1,074 (1006%)

Insurance Median: $763 (714%)

Cash: $1,074 (1006% of Medicare)

Ins. Median: $763 (714% 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 714% of the Medicare baseline (a markup of 614%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$232 - $709	217%
Unicare	$299	280%
Cdphp	$526 - $913	492%
Harvard Pilgrim	$546 - $726	511%
United	$642 - $897	601%
Aetna	$644 - $900	603%
Mgb/Allways	$653 - $794	611%
Tufts Public Plan	$660 - $661	618%
United Ri Nj Ny	$677	634%
Ambetter / Centene	$679	636%
Carelon Strategies/Bhs	$698	653%
UnitedHealthcare	$698 - $913	653%
Carelon/Beacon	$806	755%
Fallon	$819 - $828	767%
Health New England	$868	813%
Cigna	$913 - $969	855%
Ets/Lifetrac	$913	855%
Interlink Transplant	$913	855%
Community Health Options	$967	905%
Humana	$967	905%
Coventry/Hcvm/First Health	$988	925%
Multiplan/Phcs	$988 - $1,020	925%

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 $1,074.
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 Boston Children's 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.