Ultrasound, thyroid and neck
Facility: Golden Valley Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $107
- Cash Discount Price: $583
- vs. Medicare Baseline: 1.00x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Home State Health | $98 | 92% |
| UnitedHealthcare | $98 - $182 | 92% |
| Aetna | $107 | 100% |
| Humana | $107 | 100% |
| Ambetter / Centene | $128 | 120% |
Consumer Guidance & Cost Commentary
For patients paying out of pocket, the most important thing to know is that the cash median rate for this ultrasound procedure is $583. This self-pay price is significantly lower than the facility's gross chargemaster rate of $972, representing a substantial discount available to those without insurance. While commercial insurance contracts often result in higher costs due to administrative overhead and network tiering, paying cash directly can sometimes be the most affordable option, particularly for individuals with high-deductible plans where the insurer's negotiated rate might exceed the cash price. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final bill by bypassing the costly insurance claims process.
The broader financial context for this service at Golden Valley Memorial Hospital shows a stark contrast between commercial and government pricing. The facility's negotiated rate, which represents the maximum amount insurance carriers like UnitedHealthcare and Aetna will pay, is $107. This is only slightly higher than the Medicare benchmark rate of $106.81, which serves as a scientifically validated cost baseline for healthcare delivery. However, it is important to note that the median negotiated rate across all payers is $107, while the median cash rate of $583 remains the primary benchmark for self-pay patients. Although the data does not provide specific state or county average figures for comparison, patients should be aware that Medicare rates often reveal the true cost of care, with commercial rates sometimes marked up significantly above this federal standard. To avoid unexpected charges, consumers should request an itemized billing audit to ensure no errors exist before signing any consent waivers or making payments.