CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Madison County Health Care System

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $349
  • Cash Discount Price: $430
  • vs. Medicare Baseline: 3.27x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Madison County Health Care System is $349. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $430. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.27x the Medicare baseline. Located in 300 West Hutchings Street, Winterset, IA.
Cash / Self-Pay
$430

Average discount available for prompt cash payment at this facility.

Insurance Median
$349

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: $430 (403%)
Insurance Median: $349 (327%)
Cash: $430 (403% of Medicare)
Ins. Median: $349 (327% 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 327% of the Medicare baseline (a markup of 227%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $192 - $211 180%
Aetna $231 - $349 216%
Medical Associates Hp - All Plans $231 216%
Medigold-All Plans $231 216%
Tricare $231 216%
UnitedHealthcare $231 - $483 216%
American Hp Mcr Adv-All Plans $242 227%
Iowa Total Care Mcaid-All Plans $252 236%
Molina Mcaid/Chip -All Plans $261 244%
Amerigroup Mcaid-All Plans $268 251%
Madison County Sheriff-All Plans $268 251%
Oscar - All Plans $346 324%
Corvel Wc-All Plans $483 452%
Choicecare-All Plans $510 477%
First Choice-All Plans $510 477%
First Health-All Plans $510 477%
Integrated Hp-All Plans $510 477%
Mutual Of Omaha-All Plans $510 477%
Plaines Health-All Plans $510 477%
Preferred Hlth Ntwork-All Plans $510 477%
Principal Healthcare-All Plans $510 477%
Usa Managed Care-All Plans $510 477%
Medimore Employee Hp - All Plans $526 492%
Midlands Choice - All Plans $526 492%
Benefit Admin Of America-All Plans $537 503%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 West Hutchings Street, Winterset, IA 50273
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals