CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fostoria Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $405
Cash Discount Price: $497
vs. Medicare Baseline: 3.79x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fostoria Community Hospital is $405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $497. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.79x the Medicare baseline. Located in 501 Van Buren Street, Fostoria, OH.

Cash / Self-Pay

$497

Average discount available for prompt cash payment at this facility.

Insurance Median

$405

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: $497 (465%)

Insurance Median: $405 (379%)

Cash: $497 (465% of Medicare)

Ins. Median: $405 (379% 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 379% of the Medicare baseline (a markup of 279%). 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
Meridian Health Plan Of Mi	$57	53%
Paramount Health Care	$97 - $405	91%
Blue Cross Blue Shield	$99 - $496	93%
Health Alliance Plan	$99 - $574	93%
Health Value Management	$99 - $166	93%
Buckeye Community Health Plan	$102 - $171	95%
Buckeye Community Health Plan Inc	$113 - $278	106%
Aetna	$114 - $513	107%
Dayton Area Health Plan Dba Caresource	$142 - $318	133%
UnitedHealthcare	$144 - $457	135%
Amerihealth	$151	141%
Veterans Affairs	$168	157%
Medical Mutual Of Ohio	$432 - $460	404%
Frontpath Health Coalition	$441	413%
Ohio Health Choice	$497	465%
Ohio Ppo Connect	$497 - $574	465%
Health Ohio Network	$604	565%
Connecticut General Life Insurance Company	$610	571%

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 $497.
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 Fostoria Community 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.