CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Childrens Hospital of the Kings Daughters Inc

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $904
Cash Discount Price: $1,075
vs. Medicare Baseline: 8.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Childrens Hospital of the Kings Daughters Inc is $904. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,075. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.46x the Medicare baseline. Located in 601 Children's Lane, Norfolk, VA.

Cash / Self-Pay

$1,075

Average discount available for prompt cash payment at this facility.

Insurance Median

$904

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: $1,075 (1006%)

Insurance Median: $904 (846%)

Cash: $1,075 (1006% of Medicare)

Ins. Median: $904 (846% 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 846% of the Medicare baseline (a markup of 746%). 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
Blue Cross Blue Shield	$163 - $359	153%
UnitedHealthcare	$164 - $982	154%
Sentara Community Plan	$192	180%
Aetna	$201 - $982	188%
Humana	$201	188%
Amerihealth Caritas	$275	257%
Healthy Blue	$275	257%
Carolina Complete Health	$280	262%
Wellcare	$283	265%
Sentara Health Plans	$313	293%
Cigna	$793	742%
Virginia Health Network	$836 - $956	783%
Medcost	$1,016 - $1,099	951%
First Health	$1,075	1006%
Multiplan	$1,099	1029%
Phcs	$1,099 - $1,135	1029%
Vhn	$1,099 - $1,135	1029%
Johns Hopkins Healthcare	$1,135	1063%

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 $1,075.
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 Childrens Hospital of the Kings Daughters Inc 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.