CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Prisma Health Tuomey Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $198
  • Cash Discount Price: $677
  • vs. Medicare Baseline: 1.85x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Prisma Health Tuomey Hospital is $198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $677. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.85x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$677

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $677 (634%)
Insurance Median: $198 (185%)
Cash: $677 (634% of Medicare)
Ins. Median: $198 (185% 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.

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
Medicaid / KanCare $92 - $160 86%
Blue Cross Blue Shield $98 - $576 92%
Cigna $98 - $535 92%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $98 92%
Humana $98 - $782 92%
Medicare (plans) $98 - $103 92%
Triwest Healthcare Alliance Vcp [902] $98 92%
Va Community Care Network-Vaccn [903] $98 92%
Tricare $100 94%
UnitedHealthcare $101 - $240 95%
Aetna $103 - $823 96%
Healthy Conn Prime-First Choice Vip Care [5300] $103 96%
Healthy Conn Prime-Molina Healthcare [5330] $103 96%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $103 96%
Bluechoice [810] $127 - $576 119%
Workers Comp [600] $137 128%
Ambetter / Centene $180 169%
Scdc-Sc Dept Of Corrections [7232] $216 202%
Golden Rule Insurance Company [2991] $240 225%
Oxford Health Plans [2992] $240 225%
Zzumr-Salt Lake City Ut [3169] $240 225%
Prisma Health Seniorcare Pace - Midlands [5400] $242 227%
Prisma Health Seniorcare Pace-Upstate [5200] $242 227%
Bob Jones Univ-Pai [821] $267 250%
Promise Health Plan Contracted [2401] $365 - $625 342%
Orangeburg Senior Helping Center Pace [5401] $417 390%
Planned Administrators [820] $576 539%
Meritain Health Contracted [2200] $667 - $823 624%
Preferred Administrators Contracted [2839] $729 683%
Medcost [2940] $771 - $865 722%
Atlantic Packaging Contracted [4833] $782 732%
Aps Healthcare System [2981] $834 781%
Multiplan/Phcs Contracted [2950] $927 868%
Vsp Vision Care [2986] $938 878%
First Health Contracted [2952] $969 907%
Furman Int/Allen University Student [2951] $969 907%
Quiktrip-First Health [3067] $969 907%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals