CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Franklin General Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $298
Cash Discount Price: $635
vs. Medicare Baseline: 2.79x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Franklin General Hospital is $298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $635. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.79x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$635

Average discount available for prompt cash payment at this facility.

Insurance Median

$298

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: $635 (595%)

Insurance Median: $298 (279%)

Cash: $635 (595% of Medicare)

Ins. Median: $298 (279% 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 279% of the Medicare baseline (a markup of 179%). 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
Wellmark Hmo	$192	180%
Wellmark Ppo - All Other Plans	$211	198%
Medical Associates Mcare	$282	264%
Mount Carmel Hp-All Plans	$282	264%
Tricare	$282	264%
UnitedHealthcare	$282 - $586	264%
Amerigroup Mcare	$285	267%
Wellmark Mcr Adv	$285	267%
Molina Mcare	$293	274%
Ambetter / Centene	$295 - $451	276%
American Hp Iowa - All Plans	$296	277%
Amerigroup Mcaid - All Other Plans	$298	279%
Molina Mcaid - All Other Plans	$299	280%
Centivo - All Plans	$423	396%
Medical Ass Hosp Employer Group	$423	396%
Oscar - All Plans	$423	396%
Midlands Choice-All Plans	$494	463%
Medical Associates Hp-All Other Plans	$599	561%
Preferred Health Choices-All Plans	$599	561%
Splashlight Llc-All Plans	$599	561%
Aetna	$656 - $670	614%
Multiplan-All Plans	$670	627%

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 $635.
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 Franklin General 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.