CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Carolina East Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $229
Cash Discount Price: $359
vs. Medicare Baseline: 2.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Carolina East Medical Center is $229. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.14x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $359 (336%)

Insurance Median: $229 (214%)

Cash: $359 (336% of Medicare)

Ins. Median: $229 (214% 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 214% of the Medicare baseline (a markup of 114%). 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
Humana	$26 - $100	24%
Inclusive Health (Nchirp)-All Plans	$26 - $100	24%
Tricare	$26 - $944	24%
Pamlico Co Jail-All Plans	$68 - $251	64%
UnitedHealthcare	$89 - $671	83%
Medcost Ppo Employees And Retirees	$167 - $620	156%
Medcost Ppo Ultra (Employees)	$167 - $591	156%
Craven Co. Jail Systems - All Plans	$171 - $318	160%
Blue Cross Blue Shield	$177 - $647	166%
Medcost Ppo City Employees	$185 - $688	173%
Medcost Ppo County Employee	$192 - $715	180%
Benefit Mgmt, Svcs-All Plans	$216 - $802	202%
Medcost Benefit Svc-All Other Plans	$224 - $834	210%
Aetna	$225 - $836	211%
Acs Consult Svc Inc-All Plans	$229 - $853	214%
Medcost Ppo Standard	$229 - $853	214%
Cigna	$231 - $859	216%

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 $359.
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 Carolina East Medical Center 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.