CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Monmouth Medical Center-Southern Campus

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $199
Cash Discount Price: $265
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Monmouth Medical Center-Southern Campus is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.86x the Medicare baseline. Located in 600 River Ave, Lakewood, NJ.

Cash / Self-Pay

$265

Average discount available for prompt cash payment at this facility.

Insurance Median

$199

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: $265 (248%)

Insurance Median: $199 (186%)

Cash: $265 (248% of Medicare)

Ins. Median: $199 (186% 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.

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	$67 - $1,082	63%
Amerihealth	$115	108%
Aetna	$116 - $226	109%
Clover	$116	109%
Fidelis Care	$116 - $210	109%
Humana	$116	109%
Wellpoint	$116 - $635	109%
UnitedHealthcare	$119 - $206	111%
Qualcare Inc	$155 - $912	145%
Emblem Health	$203	190%
Wellcare	$231	216%
Cigna	$437	409%
First Health	$668	625%

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 $265.
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 Monmouth Medical Center-Southern Campus 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.