CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Porter Hospital Inc

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $104
Cash Discount Price: $589
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Porter Hospital Inc is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $589. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$589

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $589 (551%)

Insurance Median: $104 (97%)

Cash: $589 (551% of Medicare)

Ins. Median: $104 (97% 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.

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
UnitedHealthcare	$18 - $667	17%
Mvp	$22 - $628	21%
Fidelis Care	$23 - $285	22%
Humana	$24 - $101	22%
Aetna	$25 - $317	23%
Capital District Physicians' Health Plan	$25 - $562	23%
Martins Point	$25 - $317	23%
Veterans Affairs Community Care Network	$25 - $317	23%
Veterans Choice	$25 - $317	23%
Blue Cross Blue Shield	$29 - $635	27%
Harvard Pilgrim	$30 - $539	28%
Coventry	$33 - $593	31%
Cigna	$38 - $613	36%
Wellpath	$76 - $371	71%
Medical Corporation	$132 - $640	124%
Multiplan	$132 - $640	124%

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 $589.
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 Porter Hospital 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.