CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Stoughton Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $234
Cash Discount Price: $436
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Stoughton Hospital is $234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.19x the Medicare baseline. Located in 900 Ridge St, Stoughton, WI.

Cash / Self-Pay

$436

Average discount available for prompt cash payment at this facility.

Insurance Median

$234

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: $436 (408%)

Insurance Median: $234 (219%)

Cash: $436 (408% of Medicare)

Ins. Median: $234 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Healthnet Mcr Adv - All Plans	$22 - $356	21%
Tricare	$22 - $319	21%
Aetna	$25 - $1,138	23%
Dean Health Insurance Med Adv	$25 - $375	23%
Quartz Mcr Adv	$25 - $375	23%
Security Health/First Health - All Plans	$25 - $375	23%
UnitedHealthcare	$25 - $1,071	23%
Blue Cross Blue Shield	$28 - $1,165	26%
Humana	$32 - $1,205	30%
Quartz Health Solutions - All Other Lans	$56 - $449	52%
Alliance - All Plans	$72 - $777	67%
Medicaid / KanCare	$77 - $132	72%
Geha - All Plans	$185 - $1,004	173%
Cigna	$197 - $1,071	184%
Wisconsin Ppo Ppa Direct - All Plans	$197 - $1,071	184%
Dean Health Insurance Comm - All Other Plans	$234 - $570	219%
Dean Health Insurance Epo	$234 - $570	219%
Wps - All Plans	$1,205	1128%

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 $436.
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 Stoughton 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.