CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Decatur County Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $411
  • Cash Discount Price: $411
  • vs. Medicare Baseline: 3.85x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Decatur County Hospital is $411. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $411. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.85x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$411

Average discount available for prompt cash payment at this facility.

Insurance Median
$411

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: $411 (385%)
Insurance Median: $411 (385%)
Cash: $411 (385% of Medicare)
Ins. Median: $411 (385% 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 385% of the Medicare baseline (a markup of 285%). 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
Blue Cross Blue Shield $164 154%
Wellmark Hmo $192 180%
Wellmark Ppo - All Other Plans $211 198%
Champva -All Plans $231 216%
Everystep Hospice-All Plans $267 250%
Aetna $278 - $406 260%
Tricare $278 260%
UnitedHealthcare $308 - $437 288%
Benefit Admin System-All Plans $334 313%
Humana $375 351%
Meritain Health-All Plans $375 351%
Misc Commercial-All Plans $375 351%
All Savers-All Plans $386 361%
Allied Benefit System-All Plans $386 361%
American Family Ins Grp-All Plans $386 361%
Rural Carrier Benefit Plan-All Plans $396 371%
Christian Healthcare -All Plans $411 385%
Medica-All Other Plans $411 385%
Golden Rule-All Plans $437 409%
Ntca The Rural Broadband-All Plans $437 409%
Cigna $442 414%
Medical Mutual-All Plans $452 423%
Farm Bureau Financial-All Other Plans $463 433%
Farm Bureau Property And Ca $463 433%
Medi Share-All Plans $468 438%
Uhss-All Plans $468 438%
Health Partners-All Plans $473 443%
Lewermark-All Plans $488 457%
Mail Handlers Benefit-All Plans $504 472%
Midlands Choice-All Plans $504 472%
Priority Health-All Plans $514 481%
Iowa Total Care Mcaid-All Plans $524 491%
Amerigroup Mcaid-All Plans $540 506%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals