CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Sanford Sheldon Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $588
Cash Discount Price: $729
vs. Medicare Baseline: 5.51x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Sanford Sheldon Medical Center is $588. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $729. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.51x the Medicare baseline. Located in 118 North Seventh Avenue, Po Box 250, Sheldon, IA.

Cash / Self-Pay

$729

Average discount available for prompt cash payment at this facility.

Insurance Median

$588

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: $729 (683%)

Insurance Median: $588 (551%)

Cash: $729 (683% of Medicare)

Ins. Median: $588 (551% 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 551% of the Medicare baseline (a markup of 451%). 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
Sanford Health Plan Align	$260	243%
Ucare	$279 - $800	261%
Aetna	$282 - $792	264%
Blue Cross Blue Shield	$282	264%
Health Partners	$282 - $683	264%
Medicare (plans)	$282	264%
UnitedHealthcare	$282 - $761	264%
Primewest	$287	269%
Wellmark	$456 - $474	427%
Sanford Health Plan	$488 - $574	457%
Security Health Plan	$501	469%
Medica	$752 - $804	704%
First Choice Health Network	$820	768%
Healthez	$820	768%
Multiplan	$820	768%

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 $729.
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 Sanford Sheldon Medical Center 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.