CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Baylor Scott & White the Heart Hospital Plano

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $464
Cash Discount Price: $584
vs. Medicare Baseline: 4.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Baylor Scott & White the Heart Hospital Plano is $464. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $584. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.34x the Medicare baseline. Located in 1100 Allied Drive, Plano, TX.

Cash / Self-Pay

$584

Average discount available for prompt cash payment at this facility.

Insurance Median

$464

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: $584 (547%)

Insurance Median: $464 (434%)

Cash: $584 (547% of Medicare)

Ins. Median: $464 (434% 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 434% of the Medicare baseline (a markup of 334%). 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
Baylor Scott & White Health Plan	$96 - $564	90%
Aetna	$101 - $535	95%
Humana	$101 - $681	95%
Triwest	$101	95%
Corvel	$105	98%
Prime Health Services	$105	98%
American Health Plan	$106	99%
Blue Cross Blue Shield	$106 - $448	99%
Healthspring	$106	99%
Procare Advantage	$106	99%
Superior Health Plan	$106 - $107	99%
UnitedHealthcare	$116 - $672	109%
Ambetter / Centene	$208	195%
Cigna	$480 - $564	449%
Employers Health Network	$535	501%
Quiktrip	$535	501%
Imagine Health	$557	521%
University Of Mary Hardin-Baylor	$564	528%
Curative	$632	592%
First Health	$681	638%
Healthsmart	$681 - $730	638%
Private Health Care System	$730	683%

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 $584.
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 Baylor Scott & White the Heart Hospital Plano 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.