76536

Ultrasound scan of head and neck soft tissue

Medicare pricing data for 43,645 providers across 52 states

🤖AI Overview

Prices vary significantly by location — from $33 in Vermont to $98 in New Jersey. Where you get this procedure matters more than almost any other factor. Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.

💡 What You Should Know

Ultrasound scan of head and neck soft tissue (HCPCS code 76536) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $69.83, but hospitals typically charge $235.33 — a 3.4x markup. Prices vary significantly by state and provider.

🏷️ Typical Out-of-Pocket Cost

$13.97

Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $69.83, your out-of-pocket cost would be approximately $13.97. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.

Average Allowed Cost
$69.83
Average Hospital Charge
$235.33
Markup Ratio
3.4x

What Hospitals Charge vs. What Medicare Pays

Hospital Charge$235.33
Medicare Allowed$69.83
Medicare Payment$50.50

Hospitals charge 3.4x more than what Medicare allows for this procedure. Medicare actually pays $50.50 on average.

Cost by State

Medicare-allowed amounts vary significantly by state

StateAllowed CostHospital ChargeProvidersServicesvs. National
New Jersey$98$2971,11236,764+40.5%
District of Columbia$94$2951163,515+34.9%
Puerto Rico$93$1111651,895+33.2%
Maryland$93$22972829,011+33.0%
California$92$2774,382109,174+32.4%
New York$92$2852,484102,942+31.7%
Arizona$89$29774622,236+27.4%
Nevada$86$2944338,935+22.8%
Florida$84$2593,09181,151+20.0%
Alaska$79$4231171,929+13.6%
Connecticut$74$23459812,569+5.9%
Rhode Island$70$2551744,258+0.1%
Texas$70$2603,10463,303-0.2%
Hawaii$68$2291213,042-3.2%
Virginia$66$2321,08426,129-5.3%
Colorado$66$22273811,180-5.8%
Wyoming$66$256801,444-5.9%
North Carolina$66$2271,85731,081-6.0%
Tennessee$65$2241,28323,132-7.5%
Delaware$62$1731056,703-11.4%
Washington$61$2391,07513,691-12.2%
Kansas$60$2345008,887-14.0%
South Carolina$59$24074215,224-15.0%
Mississippi$57$1953456,933-17.8%
Georgia$57$2151,52124,323-18.6%
Alabama$56$15083711,627-19.1%
Utah$56$1663494,364-19.8%
New Mexico$56$2352275,216-20.3%
Minnesota$53$2171,26415,277-24.0%
Louisiana$53$21454410,521-24.5%
Oregon$51$1715678,606-26.3%
Illinois$51$2281,64337,811-26.9%
Kentucky$50$1435369,725-28.5%
Nebraska$50$1723626,686-29.0%
Massachusetts$50$1771,03629,050-29.0%
Idaho$48$2182173,273-31.5%
Indiana$48$17673913,313-31.6%
Iowa$48$2034337,650-31.7%
New Hampshire$47$2452514,670-33.1%
Michigan$46$1531,17522,951-34.6%
Arkansas$45$1334387,984-34.9%
Missouri$45$16189116,058-35.2%
Pennsylvania$45$1591,59340,494-35.3%
Wisconsin$45$3631,00013,039-36.1%
Oklahoma$43$1604669,529-39.1%
Ohio$42$1871,31824,697-40.1%
North Dakota$42$1691532,786-40.2%
South Dakota$39$1161982,643-44.5%
West Virginia$37$1452455,661-46.5%
Montana$37$1191381,871-46.9%
Maine$36$1312202,614-48.1%
Vermont$33$139581,601-52.5%

⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.

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💊 Need post-procedure medications? Check costs on OpenPrescriber