CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Highland District Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $224
Cash Discount Price: $539
vs. Medicare Baseline: 2.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Highland District Hospital is $224. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.10x the Medicare baseline. Located in 1275 North High Street, Hillsboro, OH.

Cash / Self-Pay

$539

Average discount available for prompt cash payment at this facility.

Insurance Median

$224

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: $539 (505%)

Insurance Median: $224 (210%)

Cash: $539 (505% of Medicare)

Ins. Median: $224 (210% 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 210% of the Medicare baseline (a markup of 110%). 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
Highland_County_Sheriff_Dept	$60	56%
Medicaid / KanCare	$60 - $63	56%
Blue Cross Blue Shield	$62 - $512	58%
Humana	$62 - $597	58%
Medicare (plans)	$216 - $222	202%
UnitedHealthcare	$216	202%
Aetna	$220 - $547	206%
Medigold	$226	212%
Immergrun_Amish	$539	505%
Medben	$539	505%
Central_Benefits_Commercial	$607	568%
Cigna	$607	568%
Medical_Mutual_Commercial	$613	574%
Uhc_	$620	580%

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 $539.
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 Highland District 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.