CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Seattle Children's Hospital
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $989
- Cash Discount Price: $1,290
- vs. Medicare Baseline: 9.26x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Seattle Children's Hospital is $989. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,290. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.26x the Medicare baseline. Located in 4800 Sand Point Way Ne, Po Box C-5371, Seattle, WA.
Cash / Self-Pay
$1,290
Average discount available for prompt cash payment at this facility.
Insurance Median
$989
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: $1,290 (1208%)
Insurance Median: $989 (926%)
Cash: $1,290 (1208% of Medicare)
Ins. Median: $989 (926% 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 926% of the Medicare baseline (a markup of 826%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Child Hearing League [17301] | $15 - $447 | 14% |
| Hospice [17306] | $15 - $447 | 14% |
| Maple Lane School [17309] | $15 - $447 | 14% |
| Medicaid / KanCare | $15 - $447 | 14% |
| Chpw [15802] | $16 - $460 | 15% |
| Coordinated Care [15815] | $16 - $469 | 15% |
| Icw Wellpoint [15822] | $16 - $469 | 15% |
| Kaiser [15818] | $16 - $456 | 15% |
| Molina [15809] | $16 - $456 | 15% |
| Opticare [15895] | $16 - $469 | 15% |
| Wellpoint [15814] | $16 - $469 | 15% |
| Ubh Community & State [15819] | $17 - $576 | 16% |
| UnitedHealthcare | $17 - $1,507 | 16% |
| Eye Quest [15894] | $18 - $469 | 17% |
| Usfhp [12208] | $32 - $727 | 30% |
| Chpw Cascade [12228] | $45 - $975 | 42% |
| Coordinated Care [12267] | $46 - $1,330 | 43% |
| Molina Marketplace [12831] | $48 - $1,330 | 45% |
| Allegiance [12264] | $56 - $1,507 | 52% |
| Cigna | $56 - $1,507 | 52% |
| Personify [12270] | $56 - $1,507 | 52% |
| Providence Health Plan [12289] | $56 - $1,507 | 52% |
| Regence Ump [12263] | $56 - $1,152 | 52% |
| Tufts Health Plan [12279] | $56 - $1,507 | 52% |
| Asuris [11900] | $59 - $1,471 | 55% |
| Asuris [11913] | $59 - $957 | 55% |
| Bridgespan Health Company [11906] | $59 - $957 | 55% |
| Pb Premera [11601] | $59 | 55% |
| Pb Regence [11908] | $59 | 55% |
| Premera [11600] | $59 - $1,471 | 55% |
| Regence [11903] | $59 - $1,471 | 55% |
| Regence [11909] | $59 - $957 | 55% |
| Aetna | $61 - $1,489 | 57% |
| Ameriben [11006] | $61 - $1,489 | 57% |
| Christian Brothers [11001] | $61 - $1,489 | 57% |
| Coresource [11004] | $61 - $1,489 | 57% |
| Ebms [11003] | $61 - $1,489 | 57% |
| Meritain [12251] | $61 - $1,684 | 57% |
| Moda [11009] | $61 - $1,489 | 57% |
| Preferred One [11008] | $61 - $1,489 | 57% |
| Web Tpa [11007] | $61 - $1,489 | 57% |
| Administrators [13102] | $62 - $1,507 | 58% |
| Allied [13129] | $62 - $1,507 | 58% |
| Assurant Health Fc [13135] | $62 - $1,507 | 58% |
| Coastal Administrative [13140] | $62 - $1,507 | 58% |
| Ebms Fc [13144] | $62 - $1,507 | 58% |
| First Choice [13399] | $62 - $1,507 | 58% |
| Health Alliance [13233] | $62 - $1,507 | 58% |
| Ilwu-Pma [13158] | $62 - $1,507 | 58% |
| Loomis Benefits West [13161] | $62 - $1,507 | 58% |
| Meritain Health [13229] | $62 - $1,507 | 58% |
| Moda Fc [13219] | $62 - $1,507 | 58% |
| Myers Stevens & Toohey [13169] | $62 - $1,507 | 58% |
| Pacific Underwriters [13175] | $62 - $1,507 | 58% |
| Personify Fc [13155] | $62 - $1,507 | 58% |
| Providence Health Plan [13181] | $62 - $1,507 | 58% |
| Rehn & Associates [13182] | $62 - $1,507 | 58% |
| Samaritan Health [12265] | $62 - $90 | 58% |
| Starmark [13103] | $62 - $1,507 | 58% |
| Tongass Timber Trust [13202] | $62 - $1,507 | 58% |
| Trusteed Plans [13186] | $62 - $1,507 | 58% |
| Trustmark Life Insurance [13203] | $62 - $1,507 | 58% |
| Welfare Pension [13120] | $62 - $1,507 | 58% |
| Wship [13121] | $62 - $1,507 | 58% |
| Zenith American Solutions [13195] | $62 - $1,507 | 58% |
| Kaiser [13400] | $64 - $1,330 | 60% |
| Kaiser [13401] | $64 - $1,152 | 60% |
| Claritev [12299] | $89 - $1,684 | 83% |
| Ebms [12241] | $89 - $1,684 | 83% |
| Health Alliance [12266] | $89 - $1,684 | 83% |
| Humana | $89 - $1,684 | 83% |
| Key Benefit Admin [12276] | $89 - $1,684 | 83% |
| Medical Mutual [12233] | $89 - $1,684 | 83% |
| Moda [12842] | $89 - $1,684 | 83% |
| Nippon Life Insurance [12232] | $89 - $1,684 | 83% |
| Pehp [12235] | $89 - $1,684 | 83% |
| Preferredone Admin Services [12236] | $89 - $1,684 | 83% |
| Select Health [12277] | $89 - $1,684 | 83% |
| Blue Cross Blue Shield | $989 - $1,471 | 926% |
| Carpenters Trust [13100] | $1,013 - $1,507 | 948% |
| Coventry Fc [13112] | $1,013 - $1,507 | 948% |
| Guardian Fc [13105] | $1,013 - $1,507 | 948% |
| Kps [13109] | $1,013 - $1,507 | 948% |
| Mega Life [13111] | $1,013 - $1,507 | 948% |
| Principal Mutual Fc [13115] | $1,013 - $1,507 | 948% |
| Psew [13124] | $1,013 - $1,507 | 948% |
| Sound Health And Wellness [13116] | $1,013 - $1,507 | 948% |
| Zenith [13123] | $1,013 - $1,507 | 948% |
| United Behavioral Health [12234] | $1,048 - $1,560 | 981% |
| Coastal Admin Svcs Contracted [12222] | $1,072 - $1,595 | 1004% |
| Personify Contracted [12205] | $1,072 - $1,595 | 1004% |
| Altius Health Plan [12275] | $1,144 - $1,702 | 1071% |
| Coventry Mhbp [12272] | $1,144 - $1,702 | 1071% |
| Coventry [12244] | $1,144 - $1,702 | 1071% |
| First Health [12210] | $1,144 - $1,702 | 1071% |
| Hcc Medical [12274] | $1,144 - $1,702 | 1071% |
| Lewermark [12286] | $1,144 - $1,702 | 1071% |
| Medishare [12287] | $1,144 - $1,702 | 1071% |
| Pacificsource [12245] | $1,144 - $1,702 | 1071% |
| Rural Carrier Benefit Plan [12271] | $1,144 - $1,702 | 1071% |