CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: OHSU Hospital and Clinics

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $235
Cash Discount Price: $713
vs. Medicare Baseline: 2.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at OHSU Hospital and Clinics is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $713. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.20x the Medicare baseline. Located in 3181 Sw Sam Jackson Park Road, Portland, OR.

Cash / Self-Pay

$713

Average discount available for prompt cash payment at this facility.

Insurance Median

$235

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: $713 (668%)

Insurance Median: $235 (220%)

Cash: $713 (668% of Medicare)

Ins. Median: $235 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
Care Oregon	$94 - $139	88%
Intercommunity Health Network	$94	88%
Kaiser Foundation Hospitals	$94 - $273	88%
Medicare (plans)	$94 - $188	88%
Pacific Source	$94 - $954	88%
Humana	$117 - $124	110%
Trillium	$117	110%
Moda	$123 - $756	115%
UnitedHealthcare	$124 - $478	116%
Aetna	$127 - $423	119%
Health Net Health Plan Of Oregon, Inc.	$135 - $950	126%
Providence Health Plan	$141 - $372	132%
Community Health Plan Of Washington	$164 - $235	154%
Tuality Health	$211	198%
Samaritan Health Plan	$293 - $674	274%
Blue Cross Blue Shield	$365	342%
Cigna	$367	344%
Coventry First Health	$727 - $920	681%
First Choice	$734 - $929	687%
Molina Exchange	$969 - $1,226	907%

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 $713.
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 OHSU Hospital and Clinics 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.