CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fairview Bethesda Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $279
Cash Discount Price: $254
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fairview Bethesda Hospital is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $254. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.61x the Medicare baseline. Located in 45 10Th St W, Saint Paul, MN.

Cash / Self-Pay

$254

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $254 (238%)

Insurance Median: $279 (261%)

Cash: $254 (238% of Medicare)

Ins. Median: $279 (261% 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 261% of the Medicare baseline (a markup of 161%). 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
Health Partners	$18 - $505	17%
Itasca Medical Care	$18 - $106	17%
Primewest	$18 - $106	17%
South Country Health Alliance	$18 - $106	17%
Medica	$19 - $468	18%
Ucare	$19 - $293	18%
Blue Cross Blue Shield	$21 - $382	20%
Hennepin Health	$21 - $108	20%
Sanford Health Plan	$25 - $382	23%
Security Health Plan	$25 - $486	23%
UnitedHealthcare	$25 - $370	23%
Wellcare	$25 - $106	23%
America'S Ppo	$318 - $467	298%
First Health	$501 - $531	469%
Multiplan	$519 - $551	486%
Private Healthcare Systems	$519 - $551	486%
Wisconsin Physician Services	$549 - $583	514%

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 $254.
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 Fairview Bethesda 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.