CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Froedtert Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $492
Cash Discount Price: $506
vs. Medicare Baseline: 4.61x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Froedtert Community Hospital is $492. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $506. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.61x the Medicare baseline. Located in 4805 S Moorland Rd, New Berlin, WI.

Cash / Self-Pay

$506

Average discount available for prompt cash payment at this facility.

Insurance Median

$492

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: $506 (474%)

Insurance Median: $492 (461%)

Cash: $506 (474% of Medicare)

Ins. Median: $492 (461% 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 461% of the Medicare baseline (a markup of 361%). 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	$103 - $639	96%
Care Wisconsin	$103	96%
Community Care	$103	96%
Health Partners	$103 - $598	96%
Humana	$103	96%
Icare	$103	96%
Molina	$103	96%
Network Health Plan	$103 - $335	96%
Security Health Plan Secure Savers	$103	96%
UnitedHealthcare	$103 - $487	96%
Chorus Community Health Plan	$368	345%
Medical College Of Wisconsin	$368	345%
Centivo	$396 - $460	371%
Cigna	$540	506%
Common Ground	$552	517%
Sheboygan Employers Health Network	$552	517%
Wisconsin Physician Services	$552	517%
Health Payment Systems	$562	526%
Trilogy	$598	560%
Americas Choice	$801	750%
Healtheos	$801	750%
Multiplan/Private Healthcare Systems	$801	750%
First Health Network	$810	758%

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 $506.
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 Froedtert 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.