CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Tristar Horizon Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $422
Cash Discount Price: $2,425
vs. Medicare Baseline: 3.95x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Tristar Horizon Medical Center is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,425. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.95x the Medicare baseline. Located in 111 Highway 70 East, Dickson, TN.

Cash / Self-Pay

$2,425

Average discount available for prompt cash payment at this facility.

Insurance Median

$422

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: $2,425 (2270%)

Insurance Median: $422 (395%)

Cash: $2,425 (2270% of Medicare)

Ins. Median: $422 (395% 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 395% of the Medicare baseline (a markup of 295%). 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
Blue Cross Blue Shield	$59 - $107	55%
Humana	$106 - $606	99%
United	$155 - $1,091	145%
Aetna	$157 - $1,212	147%
Cigna	$264 - $1,940	247%
Kentucky Labor Cabinet	$446	418%
Apex Health	$461	432%
Nhc Advantage, Inc.	$461	432%
Pruitt Health (Allyalign)	$461	432%
Centurion	$999	935%
Bgfh Singlesource	$1,212 - $2,061	1135%
Employers Health Network	$1,697	1589%
Odom'S Tn Pride Sausage	$1,819	1703%
Multiplan	$2,182	2043%
Beech Street	$2,231	2089%

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 $2,425.
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 Tristar Horizon Medical Center 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.