CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mercyone Clinton Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $240
  • Cash Discount Price: $587
  • vs. Medicare Baseline: 2.25x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mercyone Clinton Medical Center is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $587. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.25x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$587

Average discount available for prompt cash payment at this facility.

Insurance Median
$240

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: $587 (550%)
Insurance Median: $240 (225%)
Cash: $587 (550% of Medicare)
Ins. Median: $240 (225% 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 225% of the Medicare baseline (a markup of 125%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Iowa Total Care $96 90%
Medicaid / KanCare $97 - $98 91%
Bcn Domestic $107 100%
Blue Benefit Administrators Of Massachusetts $107 100%
Blue Care Network $107 100%
Blue Cross Blue Shield $107 - $110 100%
Blue Distinction Transplant $107 100%
Blue Shield - Ca $107 100%
Blue Shield - Id (Regence) $107 100%
Blue Shield - Ny Highmark Northeastern $107 100%
Blue Shield - Ny Highmark Western $107 100%
Blue Shield - Pa (Highmark) $107 100%
Blue Shield - Wa (Regence) $107 100%
Kaiser Domestic $107 100%
Pre-Employment $107 100%
Wc Domestic $107 100%
Aetna $109 - $790 102%
Medicare (plans) $109 - $114 102%
UnitedHealthcare $111 - $903 104%
Amish Hospital Aid $148 139%
Oscar $152 142%
Ambetter / Centene $187 175%
Claimdoc $224 210%
Nova $224 210%
Geha $240 225%
Health Choices $256 240%
Medical Associates $256 240%
Preferred Health Choice $261 244%
The Alliance $548 513%
1199 National Benefit Fund $790 740%
Allied Benefit Systems $790 740%
Asr Health Benefits $790 740%
Christian Brother Services $790 740%
Coventry $790 740%
First Health $790 740%
Lucent Health $790 740%
Luminare Health $790 740%
Medical Mutual $790 740%
Meritain $790 740%
Trustmark Small Business Benefits $790 740%
Webtpa $790 740%
Health Partners $792 742%
Auxiant $813 761%
Cigna $813 761%
Medica $813 761%
Midlands $813 761%
Midlands Choice $813 761%
Multiplan $813 761%
Qualcare $813 761%
Usa Managed Care $858 803%
Crime Victim Assistance $903 845%
Iowa Dept Of Public Health $903 845%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals