CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Margaretville Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $531
Cash Discount Price: $856
vs. Medicare Baseline: 4.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Margaretville Memorial Hospital is $531. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $856. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.97x the Medicare baseline. Located in 42084 State Highway 28, Margaretville, NY.

Cash / Self-Pay

$856

Average discount available for prompt cash payment at this facility.

Insurance Median

$531

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: $856 (801%)

Insurance Median: $531 (497%)

Cash: $856 (801% of Medicare)

Ins. Median: $531 (497% 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 497% of the Medicare baseline (a markup of 397%). 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
Oxford	$179	168%
UnitedHealthcare	$179 - $1,676	168%
Aetna	$289 - $2,179	271%
Mvp	$350	328%
Emblem	$361 - $425	338%
Medicare (plans)	$377 - $565	353%
Hamaspik (McR)	$377	353%
Mvp Gold (McR)	$377	353%
Blue Cross Blue Shield	$377 - $2,056	353%
Affinity By Molina McR	$395	370%
Mvp Hmo/Ppo	$413 - $1,581	387%
Cdphp	$414	388%
Emblem Ghi/Hip Ppo/Cbp	$531 - $616	497%
Mvp Exchange	$556	521%
Emblem Select Care (Exchange)	$582	545%
Oxford Exchange	$599 - $1,508	561%
Magnacare Standard	$599	561%
Todays Options	$621	581%
Magnacare Preferred	$685 - $2,267	641%
Emblem Ghi/Hip Hmo/Epo/Pos	$685	641%
Self-Pay	$699 - $2,138	654%
Multiplan	$702	657%
First Health	$770	721%

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 $856.
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 Margaretville Memorial 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.