CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mahaska Health Partnership

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $246
Cash Discount Price: $370
vs. Medicare Baseline: 2.30x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mahaska Health Partnership is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $370. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.30x the Medicare baseline. Located in 1229 C Avenue East, Oskaloosa, IA.

Cash / Self-Pay

$370

Average discount available for prompt cash payment at this facility.

Insurance Median

$246

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: $370 (346%)

Insurance Median: $246 (230%)

Cash: $370 (346% of Medicare)

Ins. Median: $246 (230% 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 230% of the Medicare baseline (a markup of 130%). 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
Aetna	$25 - $435	23%
Amerigroup Mcr Adv	$25 - $246	23%
Humana	$25 - $246	23%
UnitedHealthcare	$25 - $289	23%
Iowa Total Care Mcr	$26 - $246	24%
Iowa Total Care Comm - All Other Plans	$29 - $246	27%
Midlands Choice - All Plans	$57 - $435	53%
Medicaid / KanCare	$184 - $422	172%
Molina Mcaid - All Plans	$184 - $422	172%
Wellmark Hmo	$254	238%
Wellmark Ppo - All Other Plans	$279	261%

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 $370.
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 Mahaska Health Partnership 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.