CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Forks Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $478
Cash Discount Price: $753
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Forks Community Hospital is $478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $753. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.48x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.

Cash / Self-Pay

$753

Average discount available for prompt cash payment at this facility.

Insurance Median

$478

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: $753 (705%)

Insurance Median: $478 (448%)

Cash: $753 (705% of Medicare)

Ins. Median: $478 (448% 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 448% of the Medicare baseline (a markup of 348%). 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
Medicaid / KanCare	$165 - $515	154%
Coordinated Care (Mco) Mcd-All Plans	$179 - $524	168%
UnitedHealthcare	$213 - $1,193	199%
Community Health Network Mcr-All Other Plans	$215 - $632	201%
Humana	$215 - $632	201%
Tricare	$215 - $632	201%
Triwest-All Plans	$215 - $632	201%
Ambetter / Centene	$250 - $733	234%
Wellcare Med Adv - All Plans	$250 - $733	234%
Regence-All Other Plans	$275 - $808	257%
Community Health Exchange	$311 - $913	291%
Medicare (plans)	$318	298%
Molina Commercial-All Other Plans	$440 - $1,292	412%
Aetna	$454 - $1,334	425%
Blue Cross Blue Shield	$454 - $1,334	425%
Cigna	$478 - $1,404	448%
First Choice-All Plans	$478 - $1,404	448%

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 $753.
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 Forks 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.