CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Glens Falls Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $217
Cash Discount Price: $167
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Glens Falls Hospital is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.03x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$217

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: $167 (156%)

Insurance Median: $217 (203%)

Cash: $167 (156% of Medicare)

Ins. Median: $217 (203% 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 203% of the Medicare baseline (a markup of 103%). 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
Aetna	$28 - $271	26%
Blue Shield	$79 - $323	74%
Mvp Commercial	$82 - $334	77%
Cdphp	$126 - $436	118%
Blue Cross Blue Shield	$145 - $217	136%
Mvp	$194 - $407	182%
Fidelis	$200 - $436	187%
Hamaspik	$217	203%
Nascentia Health Options	$217	203%
Magnacare	$250	234%
Emblem	$267	250%
Empire Plan Nyship	$284	266%
Multiplan	$284	266%
UnitedHealthcare	$284	266%

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 $167.
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 Glens Falls 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.