CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Atrium Health Cleveland

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $214
Cash Discount Price: $545
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Atrium Health Cleveland is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $545. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.00x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$545

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $545 (510%)

Insurance Median: $214 (200%)

Cash: $545 (510% of Medicare)

Ins. Median: $214 (200% 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 200% of the Medicare baseline (a markup of 100%). 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
Alliance	$23 - $182	22%
Amerihealth Caritas	$23 - $154	22%
Carolina Complete Health	$23 - $157	22%
Healthy Blue	$23 - $157	22%
Partners	$23 - $153	22%
Trillium	$23 - $161	22%
UnitedHealthcare	$23 - $582	22%
Vaya	$23 - $158	22%
Wellcare	$23 - $157	22%
Cigna	$25 - $872	23%
Aetna	$26 - $839	24%
Humana	$26 - $102	24%
Blue Cross Blue Shield	$53 - $446	50%
Choicecare	$53 - $893	50%
Medcost	$72 - $722	67%
Ambetter / Centene	$348 - $396	326%
Employers Health Network	$482	451%
Physician Reach Out	$545	510%
Magellan	$654	612%
Gmmi	$708	663%
Quik Trip	$708	663%
Carolina Behavioral Health	$785 - $872	735%
Healthgram	$872	816%
First Health	$926	867%
Lifesynch Community Choice Care	$926	867%
Private Health Care Systems	$981	918%
Beechstreet	$1,002	938%
Multiplan	$1,035	969%

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 $545.
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 Atrium Health Cleveland 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.