CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Astria Toppenish Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $235
  • Cash Discount Price: $391
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Astria Toppenish Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $391. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.20x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.
Cash / Self-Pay
$391

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $391 (366%)
Insurance Median: $235 (220%)
Cash: $391 (366% of Medicare)
Ins. Median: $235 (220% 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 220% of the Medicare baseline (a markup of 120%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Medicaid / KanCare $74 - $235 69%
Ambetter / Centene $100 94%
UnitedHealthcare $100 - $510 94%
Va $100 94%
Molina $102 95%
Medicare (plans) $103 - $510 96%
Aetna $112 - $543 105%
Cigna $112 105%
Humana $112 - $617 105%
Tricare $112 105%
Zenith $113 106%
Li $116 109%
Molina_Exchange $130 122%
Regence $199 - $209 186%
Premera $221 - $233 207%
Premera_Affordable_Care $221 - $233 207%
Chpw_Cascade_Care $370 - $389 346%
First_Choice $405 - $426 379%
Kaiser $443 415%
Tpsc $458 - $481 429%
Bcchp $587 - $617 550%
Great_Rivers $587 - $617 550%
Healthcomp $587 - $617 550%
Washington_State_Hca $587 - $617 550%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 502 W Fourth Ave, Toppenish, WA 98948
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals