CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: CHI St Lukes Lakeside Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $335
Cash Discount Price: $1,158
vs. Medicare Baseline: 3.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at CHI St Lukes Lakeside Hospital is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,158. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.14x the Medicare baseline. Located in 17400 St Lukes Way, The Woodlands, TX.

Cash / Self-Pay

$1,158

Average discount available for prompt cash payment at this facility.

Insurance Median

$335

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: $1,158 (1084%)

Insurance Median: $335 (314%)

Cash: $1,158 (1084% of Medicare)

Ins. Median: $335 (314% 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 314% of the Medicare baseline (a markup of 214%). 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
Renaissance	$77	72%
Wellpoint	$105 - $160	98%
Blue Cross Blue Shield	$107 - $378	100%
Cigna	$107 - $2,316	100%
Humana	$107 - $2,151	100%
Kelsey	$107	100%
Selectcare	$107	100%
UnitedHealthcare	$107 - $2,734	100%
Aetna	$109 - $2,250	102%
United	$109 - $1,555	102%
Amerivantage	$110	103%
Devoted	$114	107%
Scanhealth	$114	107%
Kindred	$117	110%
Chc	$123 - $1,820	115%
Kelseycare	$144	135%
Ambetter / Centene	$160	150%
Community Health Choice	$160	150%
Harris Health	$160	150%
Bright Health	$182	170%
Tchp	$265 - $355	248%
Nx Health	$346	324%
Tchpchip	$1,158 - $1,456	1084%
Texastruechoice	$1,820	1704%
Coventry	$2,151	2014%
First Health	$2,151	2014%
Healthsmart	$2,316	2168%
Interlink	$2,316	2168%
Multiplan	$2,482	2324%
USA Health Network	$2,813	2634%
Mhealth Network	$3,309	3098%

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 $1,158.
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 CHI St Lukes Lakeside Hospital 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.