CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Loma Linda University Children's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $427
Cash Discount Price: $801
vs. Medicare Baseline: 4.00x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Loma Linda University Children's Hospital is $427. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $801. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.00x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$801

Average discount available for prompt cash payment at this facility.

Insurance Median

$427

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: $801 (750%)

Insurance Median: $427 (400%)

Cash: $801 (750% of Medicare)

Ins. Median: $427 (400% 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 400% of the Medicare baseline (a markup of 300%). 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)	$100 - $135	94%
Kaiser Foundation Hospitals	$114 - $1,187	107%
Alpha Care Medical Group	$135 - $203	126%
Dignity Health	$135 - $203	126%
Epic Health Plan	$135 - $712	126%
Upland Medical Group	$135	126%
Vantage Medical Group	$135 - $203	126%
Molina Healthcare Of Ca	$170 - $181	159%
Heritage Provider Network	$222	208%
UnitedHealthcare	$247	231%
Adventist Health	$356	333%
Lluh Dept Of Risk Management	$427	400%
Blue Shield Of California	$719 - $1,089	673%
Global Benefits Group	$1,067	999%
Temecula Valley Physicians Medical Group	$1,067	999%
Trivalley Medical Group	$1,067	999%
Blue Cross Blue Shield	$1,092	1022%
Cigna	$1,139 - $1,316	1066%
Networks By Design	$1,156	1082%
Aetna	$1,167	1093%
Multiplan	$1,423	1332%
Galaxy Health	$1,512	1416%
Prime Health Services	$1,512	1416%

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 $801.
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 Children's 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.