CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Southeast Iowa Regional Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $156
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Southeast Iowa Regional Medical Center is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.46x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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%)

Insurance Median: $156 (146%)

Ins. Median: $156 (146% 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.

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
American Healthplan Of Iowa - Midlevel	$21 - $84	20%
Medicaid / KanCare	$23 - $76	22%
Aetna	$25 - $100	23%
Humana	$26 - $104	24%
American Healthplan Of Iowa - Md	$28 - $110	26%
Blue Cross Blue Shield	$47 - $272	44%
UnitedHealthcare	$52 - $208	49%
Midlands Choice	$57 - $630	53%
Immergrun	$67	63%
6 Degree	$85 - $560	80%
Plain Church	$112 - $455	105%
Absolute Solutions	$156 - $321	146%
First Agency	$156 - $321	146%
Multiplan	$156 - $321	146%
Henderson County	$164 - $339	154%
Elap	$209 - $298	196%
Wellpoint (Amerigroup)	$392	367%
Immugrun	$441	413%
Brighton Amish Church	$455	426%
Geha	$651	609%

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 $X.
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 Southeast Iowa Regional 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.