CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Southwest Health Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $534
Cash Discount Price: $538
vs. Medicare Baseline: 5.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Southwest Health Center is $534. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $538. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.00x the Medicare baseline. Located in 1400 East Side Rd, Platteville, WI.

Cash / Self-Pay

$538

Average discount available for prompt cash payment at this facility.

Insurance Median

$534

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: $538 (504%)

Insurance Median: $534 (500%)

Cash: $538 (504% of Medicare)

Ins. Median: $534 (500% 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 500% of the Medicare baseline (a markup of 400%). 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	$184 - $820	172%
Care Wisconsin	$184 - $533	172%
UnitedHealthcare	$191 - $672	179%
Quartz	$381 - $640	357%
Wps	$461 - $615	432%
Cigna	$461 - $615	432%
Group Health Cooperative of Sc	$492 - $713	461%
Humana	$554 - $738	519%
Healthchoice	$584 - $779	547%
Group Health Eau Claire	$615 - $820	576%
Group Health South Central	$615 - $820	576%
Dean Health Plan	$615 - $620	576%

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 $538.
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 Southwest Health 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.