CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Marys Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $98
Cash Discount Price: $764
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Marys Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $764. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.92x the Medicare baseline. Located in 2900 1St Avenue, Huntington, WV.

Cash / Self-Pay

$764

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $764 (715%)

Insurance Median: $98 (92%)

Cash: $764 (715% of Medicare)

Ins. Median: $98 (92% 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
The Healthplan	$20 - $72	19%
Unicare	$20 - $72	19%
Aetna	$25 - $688	23%
Blue Cross Blue Shield	$25 - $743	23%
Humana	$25 - $106	23%
Peak Health	$25 - $650	23%
Peia	$25 - $118	23%
UnitedHealthcare	$25 - $723	23%
Caresource	$28 - $726	26%
Medicare (plans)	$106	99%
Cigna	$696	652%
Firsthealth	$726	680%
Healthsmart	$726	680%
Phcs Multiplan	$726	680%
Zelis Network	$726	680%

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 $764.
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 St Marys Medical Center 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.