CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Ellenville Regional Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $114
Cash Discount Price: $152
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Ellenville Regional Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.07x the Medicare baseline. Located in 10 Healthy Way, Ellenville, NY.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $152 (142%)

Insurance Median: $114 (107%)

Cash: $152 (142% of Medicare)

Ins. Median: $114 (107% 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
UnitedHealthcare	$13 - $489	12%
Emblemhealth	$29 - $256	27%
Cdphp	$31 - $118	29%
Blue Cross Blue Shield	$34 - $128	32%
Fidelis	$34 - $128	32%
Hamaspik Choice	$34 - $128	32%
Humana	$34 - $128	32%
Mvp Health Care Of Ny	$35 - $240	33%
Aetna	$39 - $224	37%
Local 1199Seiu	$39 - $224	37%
Wellcare	$46 - $176	43%
Galaxy Health	$55 - $208	51%
Oxford Health Plans	$489	458%

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 $152.
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 Ellenville Regional 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.