CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fort Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $93
Cash Discount Price: $201
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fort Memorial Hospital is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.87x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$201

Average discount available for prompt cash payment at this facility.

Insurance Median

$93

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: $201 (188%)

Insurance Median: $93 (87%)

Cash: $201 (188% of Medicare)

Ins. Median: $93 (87% 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
Blue Cross Blue Shield	$21 - $300	20%
Mercycare	$24 - $567	22%
Dean Health Plan	$25 - $851	23%
Humana	$25 - $125	23%
Molina	$25 - $109	23%
Quartz	$25 - $814	23%
UnitedHealthcare	$25 - $124	23%
Managed Health Services	$27 - $49	25%
Aetna	$41 - $571	38%
Medicaid / KanCare	$45	42%
Alliance	$69 - $547	65%
Fort Care	$84 - $343	79%
Centivo	$85 - $500	80%
Medicare (plans)	$102	95%
Group Health Cooperative	$106 - $493	99%
Veteran Evaluation Services	$127	119%
Trilogy	$154 - $670	144%
Cigna	$166 - $724	155%

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 $201.
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 Fort Memorial 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.