CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Maimonides Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $29
Cash Discount Price: $320
vs. Medicare Baseline: 0.27x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Maimonides Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.27x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.

Cash / Self-Pay

$320

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $320 (300%)

Insurance Median: $29 (27%)

Cash: $320 (300% of Medicare)

Ins. Median: $29 (27% 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
United Community Plan	$13 - $144	12%
UnitedHealthcare	$13 - $172	12%
Blue Cross Blue Shield	$16 - $382	15%
Cigna	$18 - $213	17%
Healthfirst	$18 - $128	17%
Aetna	$22 - $130	21%
Centers Plan For Healthy Living	$23 - $29	22%
Elderplan	$23 - $29	22%
Fidelis	$23 - $34	22%
Healthfirst Early Start	$23 - $24	22%
Metroplus	$23 - $157	22%
Emblem Health - Hip	$24 - $30	22%
Visiting Nurse Svc Of Ny	$24 - $42	22%
Emblem Health - Hip Vip	$28 - $29	26%
Wellcare	$28 - $29	26%
Emblem Health - Ghi	$29 - $397	27%
Molina	$29 - $54	27%
Villagecare Maxx Fida	$29	27%
Local 1199	$36 - $73	34%
Oxford Health Plan	$172	161%
Oxford Liberty	$172	161%

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 $320.
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 Maimonides 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.