CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Carilion Tazewell Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $758
Cash Discount Price: $522
vs. Medicare Baseline: 7.10x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Carilion Tazewell Community Hospital is $758. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $522. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.10x the Medicare baseline. Located in 388 Ben Bolt Avenue, Tazewell, VA.

Cash / Self-Pay

$522

Average discount available for prompt cash payment at this facility.

Insurance Median

$758

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: $522 (489%)

Insurance Median: $758 (710%)

Cash: $522 (489% of Medicare)

Ins. Median: $758 (710% 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 710% of the Medicare baseline (a markup of 610%). 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
Corvel	$89	83%
Aetna	$92 - $989	86%
Humana	$94 - $103	88%
Allcare	$98	92%
Blue Cross Blue Shield	$99 - $552	93%
Sentara Health Plan	$101 - $924	95%
UnitedHealthcare	$101 - $1,218	95%
Abh Of Va (Formerly Coventry)	$103	96%
Abh Of Wva (Formerly Coventry)	$103	96%
Gateway - Tier 3	$820	768%
Vhn - Ultra	$924	865%
Cigna	$946 - $1,009	886%
Connecticare	$1,043	977%
Vhn - Plus	$1,147	1074%
Gateway - Tier 2	$1,192	1116%
Vhn	$1,192	1116%
Integrated Health Plan	$1,266	1185%
Vhn - Link	$1,341	1256%
Gateway - Tier 1	$1,416	1326%
Vhn - Secondary Payors	$1,416	1326%
National Provider Network	$1,430	1339%

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 $522.
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 Carilion Tazewell Community 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.