CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Charleston Area Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $211
Cash Discount Price: $1,210
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Charleston Area Medical Center is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,210. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.98x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$1,210

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $1,210 (1133%)

Insurance Median: $211 (198%)

Cash: $1,210 (1133% of Medicare)

Ins. Median: $211 (198% 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
Tricare	$44 - $829	41%
Aetna	$59 - $1,354	55%
The Health Plan Of West Virginia Inc.	$59 - $1,341	55%
Unicare Health Plan Of West Virginia Inc.	$59 - $348	55%
Integrated Medical Solutions	$66 - $674	62%
Three Rivers Providers Network	$71 - $1,341	66%
Triwest Va	$71 - $335	66%
Cigna	$72 - $1,285	67%
Healthsmart	$72 - $1,354	67%
Multiplan	$72 - $1,354	67%
Blue Cross Blue Shield	$73 - $1,260	68%
Caresource	$73 - $864	68%
Choicecare Network	$73 - $1,354	68%
City Of Charleston	$73 - $1,036	68%
Naphcare	$73 - $691	68%
Optimum Choice Inc.	$73 - $107	68%
UnitedHealthcare	$73 - $1,354	68%
West Virginia Senior Advantage Inc.	$77 - $363	72%

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 $1,210.
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 Charleston Area 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.