CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Cook Childrens Medical Center Prosper

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $449
Cash Discount Price: $624
vs. Medicare Baseline: 4.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Cook Childrens Medical Center Prosper is $449. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $624. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.20x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$624

Average discount available for prompt cash payment at this facility.

Insurance Median

$449

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: $624 (584%)

Insurance Median: $449 (420%)

Cash: $624 (584% of Medicare)

Ins. Median: $449 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
United Community	$89 - $447	83%
UnitedHealthcare	$105 - $1,026	98%
Aetna	$122 - $1,026	114%
Beacon	$129 - $652	121%
El Paso Health First	$129 - $652	121%
Health Plan W/O Uhrip	$129 - $652	121%
Tx Children Health	$129 - $652	121%
Health Plan W. Uhrip	$135	126%
Firstcare	$136 - $966	127%
Wellpoint	$141	132%
Blue Cross Blue Shield	$145 - $1,086	136%
Superior Health	$145	136%
S&W Health	$201 - $1,014	188%
Cigna	$204 - $1,026	191%
Healthscope	$204 - $1,026	191%
Imagine Health	$204 - $1,026	191%
Humana	$208 - $1,062	195%
Multiplan	$208 - $1,050	195%
First Health	$211 - $1,062	198%
Galaxy Health	$216 - $1,086	202%
Healthsmart	$216 - $1,086	202%
Usamco	$220 - $1,111	206%

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 $624.
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 Cook Childrens Medical Center Prosper 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.