CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $177
  • Cash Discount Price: $240
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at The Orthopaedic Hospital of Lutheran Health Networ is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.66x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$240

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $240 (225%)
Insurance Median: $177 (166%)
Cash: $240 (225% of Medicare)
Ins. Median: $177 (166% 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.

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
Physicians Health Plan $17 - $661 16%
Amish Aid $20 - $460 19%
Self Pay $20 - $460 19%
Lutheran Preferred $21 - $1,022 20%
Php Freedom Network $23 - $314 22%
Cigna $26 - $1,704 24%
Aetna $28 - $826 26%
Three Rivers Preferred $29 - $767 27%
Sagamore $35 - $922 33%
Encore Ppo $36 - $852 34%
Multiplan $50 - $1,329 47%
Prime Health Services $55 - $1,278 51%
First Health $56 - $1,312 52%
Encore $58 - $1,363 54%
UnitedHealthcare $98 - $840 92%
Tricare $105 98%
One Call Work Comp $106 99%
Blue Cross Blue Shield $109 - $455 102%
Humana $109 - $256 102%
Iu Health Plan $109 102%
Medicare (plans) $109 102%
Node Mhs Mcr Adv $109 102%
Small Business Aid $109 102%
Department Of Veterans Affairs $111 104%
Node Devoted Health Mcr Adv $111 104%
Node Hospice Non Par Agree $111 104%
Node Va $111 104%
Police And Sheriff $113 106%
In Dept Of Correction $115 108%
Node Pphp Mcr Adv $116 109%
Node Us Dept Of Labor $138 129%
Lutheran Advanced Network $166 155%
Node Lutheran Three Rivers Preferred Plus 150 $166 155%
Occunet In Work Comp $166 155%
Align Network $177 166%
Node Lutheran Three Rivers Preferred Plus 175 $194 182%
Medicaid / KanCare $197 - $256 184%
Encore Wc $199 186%
Medrisk In Work Comp $199 186%
Three Rivers Preferred In Work Comp $199 186%
Objective Surgical $216 202%
In Work Comp $221 207%
Lutheran Network $221 207%
Managed Health Services $221 - $256 207%
Caresource $256 240%
Mhs $256 240%
Encore Kba Epo $265 248%
Encore Kba Ppo $332 311%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals