CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: The McDowell Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $577
Cash Discount Price: $1,244
vs. Medicare Baseline: 5.40x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at The McDowell Hospital is $577. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,244. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.40x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$1,244

Average discount available for prompt cash payment at this facility.

Insurance Median

$577

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: $1,244 (1165%)

Insurance Median: $577 (540%)

Cash: $1,244 (1165% of Medicare)

Ins. Median: $577 (540% 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 540% of the Medicare baseline (a markup of 440%). 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	$166	155%
United	$168 - $639	157%
Wellcare	$171	160%
Amerihealth	$172	161%
Partners Health Management	$174	163%
Vaya Health	$174	163%
Apex Health	$249	233%
Cigna	$427 - $665	400%
Caresource	$547	512%
Medcost	$609 - $1,057	570%
Magellan	$746	698%
Magellan Behavioral Health	$746	698%
Aetna	$899	842%
Multiplan	$995	932%
Avalon Administrative Services	$1,057	990%
Prime Health	$1,094 - $1,119	1024%

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 $1,244.
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 The McDowell 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.