CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Limestone Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $184
Cash Discount Price: $373
vs. Medicare Baseline: 1.72x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Limestone Medical Center is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $373. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.72x the Medicare baseline. Located in 701 McClintic Drive, Groesbeck, TX.

Cash / Self-Pay

$373

Average discount available for prompt cash payment at this facility.

Insurance Median

$184

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: $373 (349%)

Insurance Median: $184 (172%)

Cash: $373 (349% of Medicare)

Ins. Median: $184 (172% 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.

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	$114 - $180	107%
Medicaid / KanCare	$135	126%
Humana	$180 - $466	169%
Medicare (plans)	$180	169%
UnitedHealthcare	$180 - $384	169%
Pphp	$184	172%
Cigna	$435	407%
Aetna	$497	465%

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 $373.
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 Limestone 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.