CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Boone County Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $454
Cash Discount Price: $806
vs. Medicare Baseline: 4.25x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Boone County Hospital is $454. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $806. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.25x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$806

Average discount available for prompt cash payment at this facility.

Insurance Median

$454

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: $806 (755%)

Insurance Median: $454 (425%)

Cash: $806 (755% of Medicare)

Ins. Median: $454 (425% 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 425% of the Medicare baseline (a markup of 325%). 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
Tricare	$107	100%
Wellmark Hmo	$187	175%
Wellmark Ppo - All Other Plans	$206	193%
Choice Care Mcr Adv - All Plans	$413	387%
Humana	$413 - $907	387%
Iowa Hlth Adv - All Plans	$413	387%
Mt Carmel Hp - All Plans	$413	387%
UnitedHealthcare	$413 - $592	387%
Va Ccn-All Plans	$413	387%
Amerigroup Mcr Adv - All Other Plans	$417	390%
Aetna	$422 - $786	395%
Meridian Mcaid - All Plans	$454	425%
Iowa Total Care Mcaid - All Plans	$463	433%
Medicaid / KanCare	$467	437%
Healthsmart Accell Network	$706	661%
Medical Associates Hp-All Plans	$756	708%
Healthsmart Ppo - All Other Plans	$806	755%
Health Alliance-All Plans	$907	849%
Midlands Choice-All Plans	$927	868%
Mutually Preferred-All Plans	$957	896%

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 $806.
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 Boone 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.