CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Nicholas Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $164
  • Cash Discount Price: $552
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Nicholas Hospital is $164. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $552. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.54x the Medicare baseline. Located in 3100 Superior Ave, Sheboygan, WI.
Cash / Self-Pay
$552

Average discount available for prompt cash payment at this facility.

Insurance Median
$164

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: $552 (517%)
Insurance Median: $164 (154%)
Cash: $552 (517% of Medicare)
Ins. Median: $164 (154% 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.

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 $23 - $696 22%
Community Care Family Care $23 - $47 22%
Managed Health Services $23 - $47 22%
Medicaid / KanCare $23 - $47 22%
Meridian Health Plan $23 - $47 22%
Molina Healthcare $25 - $103 23%
Triology $25 - $661 23%
Security Health Plan $42 - $534 39%
Aetna $51 - $837 48%
Humana $51 - $711 48%
Medica $51 - $103 48%
Medicare (plans) $51 - $103 48%
UnitedHealthcare $51 - $545 48%
Naphcare $116 - $231 109%
Molina Healthcare Of Wi $418 391%
Hshs Employees $454 425%
P360 Small Group $482 451%
Prevea Health Network $482 451%
Arise Health Plan $502 470%
Wea Provider Network $519 - $603 486%
Cigna $586 549%
Interplan $586 549%
Network Health Plan $586 549%
Health Care Alliance $611 572%
Health Eos $628 588%
Healthsmart $628 588%
Wisconsin Physician Service $670 627%
Multiplan/Phcs $703 658%
Choicecare $711 666%
North Central Healthcare Alliance $770 721%
First Health $795 744%
Caterpillar, Inc. $837 784%
Cofinity $837 784%
Live360 $837 784%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Superior Ave, Sheboygan, WI 53081
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals