CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Holy Family Memorial

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $431
Cash Discount Price: $359
vs. Medicare Baseline: 4.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Holy Family Memorial is $431. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.04x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$431

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: $359 (336%)

Insurance Median: $431 (404%)

Cash: $359 (336% of Medicare)

Ins. Median: $431 (404% 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 404% of the Medicare baseline (a markup of 304%). 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
Blue Cross Blue Shield	$101 - $579	95%
Community Care Incorporated	$101	95%
Health Partners	$101 - $424	95%
Humana	$101	95%
Icare	$101	95%
Molina	$101 - $109	95%
Network Health Plan	$101 - $434	95%
Security Health Plan	$101 - $522	95%
UnitedHealthcare	$101 - $647	95%
Allwell	$103	96%
Medical College Of Wisconsin	$215	201%
Centivo	$261 - $300	244%
Dean Health Plan	$326	305%
Health Payment Systems	$368	345%
Sheboygan Employers Health Network	$391	366%
Chorus Community Health Plan	$419	392%
Trilogy	$430	403%
Cigna	$469	439%
Wps Health Plan	$482	451%
Aspirus	$522	489%
Healtheos	$522	489%
Multiplan/Private Healthcare Systems	$522	489%
Preferred One	$522	489%
Healthsmart	$541	507%
First Health Network	$574	537%

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 $359.
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 Holy Family Memorial 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.