CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Hermann Area District Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $547
Cash Discount Price: $566
vs. Medicare Baseline: 5.12x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Hermann Area District Hospital is $547. 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 5.12x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$566

Average discount available for prompt cash payment at this facility.

Insurance Median

$547

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: $547 (512%)

Cash: $566 (530% of Medicare)

Ins. Median: $547 (512% 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 512% of the Medicare baseline (a markup of 412%). 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
Healthy Blue Mcaid - All Plans	$70	66%
Ambetter / Centene	$73 - $664	68%
Blue Cross Blue Shield	$76 - $768	71%
UnitedHealthcare	$76 - $396	71%
Tricare	$374	350%
Choicecare Mcr Adv- All Plans	$396	371%
American Hlth Mcr Adv- All Plans	$415	389%
Humana	$415	389%
Aetna	$423 - $896	396%
Wellcare Mcr Adv - All Plans	$423	396%
Harmony Hp Mcaid- All Plans	$547	512%
Cigna	$560	524%
Care Partners Mcaid- All Plans	$562	526%
Healthcare Usa Mcaid- All Plans	$613	574%
Healthlink Hmo	$613	574%
Healthlink Ppo - All Other Plans	$708	663%
Multiplan/Phcs - All Plans	$708	663%
Coventry - All Plans	$802	751%
Comp Results - All Plans	$849	795%
Three Rivers - All Plans	$849	795%

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 Hermann Area District 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.