CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Loma Linda University Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $366
Cash Discount Price: $824
vs. Medicare Baseline: 3.43x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Loma Linda University Medical Center is $366. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $824. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.43x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.

Cash / Self-Pay

$824

Average discount available for prompt cash payment at this facility.

Insurance Median

$366

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: $824 (771%)

Insurance Median: $366 (343%)

Cash: $824 (771% of Medicare)

Ins. Median: $366 (343% 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 343% of the Medicare baseline (a markup of 243%). 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
Inland Empire Health Plan (Iehp)	$103 - $135	96%
Kaiser Foundation Hospitals	$114 - $1,221	107%
Adventist Health	$135 - $366	126%
Alpha Care Medical Group	$135 - $203	126%
Dignity Health	$135 - $203	126%
Epic Health Plan	$135 - $732	126%
UnitedHealthcare	$135 - $247	126%
Upland Medical Group	$135	126%
Vantage Medical Group	$135 - $203	126%
Prime Health Services	$143 - $1,556	134%
Riverside University Health System	$149	140%
Molina Healthcare Of Ca	$181	169%
Heritage Provider Network	$222	208%
Blue Cross Blue Shield	$296 - $1,075	277%
Lluh Dept Of Risk Management	$366	343%
Blue Shield Of California	$727 - $1,111	681%
Global Benefits Group	$1,099	1029%
Temecula Valley Physicians Medical Group	$1,099	1029%
Trivalley Medical Group	$1,099	1029%
Aetna	$1,112	1041%
Cigna	$1,172 - $1,355	1097%
Networks By Design	$1,190	1114%
Multiplan	$1,373	1285%
Central Health Plan	$1,465	1372%
Galaxy Health	$1,556	1457%
Health Management Network	$1,648	1543%

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 $824.
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 Loma Linda University 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.