CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Monroe County Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $342
Cash Discount Price: $415
vs. Medicare Baseline: 3.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Monroe County Hospital is $342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.20x the Medicare baseline. Located in 6580 165Th Street, Albia, IA.

Cash / Self-Pay

$415

Average discount available for prompt cash payment at this facility.

Insurance Median

$342

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: $415 (389%)

Insurance Median: $342 (320%)

Cash: $415 (389% of Medicare)

Ins. Median: $342 (320% 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 320% of the Medicare baseline (a markup of 220%). 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	$140	131%
Wellmark Ppo - All Other Plans	$150	140%
Mahp Mcare - All Plans	$290	272%
Tricare	$290	272%
UnitedHealthcare	$290 - $656	272%
Va Ccn - All Plans	$290	272%
Amerigroup Mcare	$293	274%
Humana	$293	274%
Wellmark Mcare	$293	274%
Aetna	$296 - $650	277%
Iowa Total Care Mcaid - All Plans	$345	323%
Molina Mcaid - All Plans	$350	328%
Amerigroup Mcaid - All Other Plans	$356	333%
Centivo - All Plans	$435	407%
Midlands Choice - All Plans	$484	453%
Preferred Hlth - All Plans	$518	485%
Geha - All Plans	$553	518%
Multiplan - All Plans	$622	582%
Integrated Hp - 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 $415.
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 Monroe County 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.