CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Transylvania Regional Hospital, Inc

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $510
Cash Discount Price: $1,244
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Transylvania Regional Hospital, Inc is $510. 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 4.77x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$1,244

Average discount available for prompt cash payment at this facility.

Insurance Median

$510

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: $510 (477%)

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

Ins. Median: $510 (477% 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 477% of the Medicare baseline (a markup of 377%). 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	$235 - $249	220%
United	$238 - $560	223%
Wellcare	$242	227%
Amerihealth	$244	228%
Partners Health Management	$247	231%
Vaya Health	$247	231%
Apex Health	$249	233%
Aetna	$323 - $899	302%
Cigna	$455 - $633	426%
Amerihealth Caritas	$510	477%
Caresource	$547	512%
Medcost	$696 - $1,057	652%
Magellan	$746	698%
Magellan Behavioral Health	$746	698%
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 Transylvania Regional Hospital, Inc 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.