CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Trinity Health Oakland Hospital
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $571
- Cash Discount Price: $546
- vs. Medicare Baseline: 5.35x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Trinity Health Oakland Hospital is $571. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $546. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.35x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$546
Average discount available for prompt cash payment at this facility.
Insurance Median
$571
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: $546 (511%)
Insurance Median: $571 (535%)
Cash: $546 (511% of Medicare)
Ins. Median: $571 (535% 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 535% of the Medicare baseline (a markup of 435%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Medicaid / KanCare | $57 - $58 | 53% |
| Blue Cross Blue Shield | $58 - $184 | 54% |
| Aetna | $102 - $381 | 95% |
| Blue Care Network Advantage | $102 | 95% |
| Medicare (plans) | $102 - $104 | 95% |
| Align Senior Care | $104 | 97% |
| Hospice Advantage | $104 | 97% |
| UnitedHealthcare | $107 - $630 | 100% |
| Cca - Zing Health | $110 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $117 | 110% |
| Molina Marketplace | $135 | 126% |
| Priority Health | $149 - $165 | 140% |
| Health Cost Solutions | $161 | 151% |
| Vitalcore | $161 | 151% |
| Wellpath | $161 | 151% |
| Bcn Domestic | $184 | 172% |
| Blue Benefit Administrators Of Massachusetts | $184 | 172% |
| Blue Care Network | $184 | 172% |
| Blue Distinction Transplant | $184 | 172% |
| Blue Shield - Ca | $184 | 172% |
| Blue Shield - Id (Regence) | $184 | 172% |
| Blue Shield - Ny Highmark Northeastern | $184 | 172% |
| Blue Shield - Ny Highmark Western | $184 | 172% |
| Blue Shield - Pa (Highmark) | $184 | 172% |
| Blue Shield - Wa (Regence) | $184 | 172% |
| Health Choices | $184 - $617 | 172% |
| Kaiser Domestic | $184 | 172% |
| Asr Health Benefits | $186 | 174% |
| Caresource | $186 | 174% |
| Hap | $186 - $612 | 174% |
| Varipro | $186 | 174% |
| U Of M Health Plan | $238 | 223% |
| Employee Benefit Logistic | $240 | 225% |
| Wc Accident Fund | $255 | 239% |
| Wc Advantage | $255 | 239% |
| Wc Aig | $255 | 239% |
| Wc Allied | $255 | 239% |
| Wc Amerisure | $255 | 239% |
| Wc Amtrust | $255 | 239% |
| Wc Asu Risk Mgt | $255 | 239% |
| Wc Berkley Admin | $255 | 239% |
| Wc Broadspire | $255 | 239% |
| Wc Bunch & Associates | $255 | 239% |
| Wc Ccmsi | $255 | 239% |
| Wc Emc Insurance Company | $255 | 239% |
| Wc Esis | $255 | 239% |
| Wc Fcci | $255 | 239% |
| Wc Federated | $255 | 239% |
| Wc Gallagher Bassett | $255 | 239% |
| Wc Genex Care For Ohio | $255 | 239% |
| Wc Guard Insurance Company | $255 | 239% |
| Wc Hartford | $255 | 239% |
| Wc Liberty Mutual | $255 | 239% |
| Wc Meijers | $255 | 239% |
| Wc Michigan | $255 | 239% |
| Wc Mitchell Frankenmuth | $255 | 239% |
| Wc Pma | $255 | 239% |
| Wc Sedgwick | $255 | 239% |
| Wc Sentry | $255 | 239% |
| Wc Travelers | $255 | 239% |
| Wc Tristar | $255 | 239% |
| Wc Walmart | $255 | 239% |
| Wc Zurich | $255 | 239% |
| Geha | $294 - $630 | 275% |
| Medical Mutual | $294 | 275% |
| Meritain | $294 | 275% |
| Acs Benefit Services | $370 | 346% |
| Allied Benefit Systems | $370 | 346% |
| Claimchoice Adminstrators | $370 | 346% |
| Consociate | $370 | 346% |
| Cypress Benefit Administrators | $370 | 346% |
| Forest County Potawatomi | $370 | 346% |
| Health Smart | $370 | 346% |
| Healthgram | $370 | 346% |
| Healthscope | $370 | 346% |
| Secureone Preferred United Plans | $370 | 346% |
| Sisco Benefits | $370 | 346% |
| The Health Plan | $370 | 346% |
| Trustmark Small Business Benefits | $370 | 346% |
| Unified Group Services | $370 | 346% |
| Webtpa | $370 | 346% |
| Mclaren Health | $404 - $440 | 378% |
| Carelon Behavioral Health | $420 | 393% |
| Magellan Behavioral Health | $504 | 472% |
| 1199 National Benefit Fund | $571 | 535% |
| Allied National Global Care | $571 | 535% |
| Asrm - Reliance Standard Life Insurance | $571 | 535% |
| Christian Care Ministry | $571 | 535% |
| Dean Health | $571 | 535% |
| Fallon Health | $571 | 535% |
| Family Life Insurance Company | $571 | 535% |
| Ghc Scw | $571 | 535% |
| Group Pension Administrators | $571 | 535% |
| International Benefit Administrators | $571 | 535% |
| Lifetime Benefit Solutions | $571 | 535% |
| Manhattan Life | $571 | 535% |
| Medi Share | $571 | 535% |
| Multiplan | $571 | 535% |
| Mvp | $571 | 535% |
| Pai | $571 | 535% |
| Pan-American Life | $571 | 535% |
| Paramount Hmo | $571 | 535% |
| Phcs | $571 | 535% |
| Trinity Health Share | $571 | 535% |
| Health Partners | $612 | 573% |
| Tufts Health Plan | $612 | 573% |
| Access Health | $617 | 578% |
| Acclaim | $617 | 578% |
| Administrative Concepts | $617 | 578% |
| Allegeant | $617 | 578% |
| Ameriben | $617 | 578% |
| American Family | $617 | 578% |
| American Healthcare Alliance | $617 | 578% |
| American National | $617 | 578% |
| American Republic | $617 | 578% |
| Amerihealth | $617 | 578% |
| Aultcare | $617 | 578% |
| Automated Benefit Services | $617 | 578% |
| Auxiant | $617 | 578% |
| Benefit Administrative Systems,Llc | $617 | 578% |
| Boon Chapman | $617 | 578% |
| Cam Administrative Services | $617 | 578% |
| Christian Brother Services | $617 | 578% |
| Christian Brothers Holy Cross | $617 | 578% |
| Comprehensive Benefits | $617 | 578% |
| Continental Life Insurance | $617 | 578% |
| Custom Benefit Administrators | $617 | 578% |
| Employee Benefit Concepts | $617 | 578% |
| Employee Benefit Management | $617 | 578% |
| Enterprise Group Planning | $617 | 578% |
| Freedom Life Insurance Company | $617 | 578% |
| Group Administrators | $617 | 578% |
| Group Marketing Services | $617 | 578% |
| Guardian | $617 | 578% |
| Health America | $617 | 578% |
| Healthcare Management Admin | $617 | 578% |
| Healthez | $617 | 578% |
| Humana | $617 | 578% |
| Insight | $617 | 578% |
| Intercare | $617 | 578% |
| Jfp Benefit Management | $617 | 578% |
| Jp Farley Corporation | $617 | 578% |
| Key Benefit Administrator | $617 | 578% |
| Liberty Union Life Assurance Co | $617 | 578% |
| Lucent Health | $617 | 578% |
| Luminare Health | $617 | 578% |
| Luminare Health (Detroit) | $617 | 578% |
| Magnacare | $617 | 578% |
| Medben | $617 | 578% |
| Medcost | $617 | 578% |
| Mutual Health Services | $617 | 578% |
| Mutual Of Omaha | $617 | 578% |
| Ncas | $617 | 578% |
| Nippon Life Ins | $617 | 578% |
| Nova | $617 | 578% |
| Painters Union Insurance Fund | $617 | 578% |
| Physicians Mutual | $617 | 578% |
| Plumbers Local 98 Insurance Fund | $617 | 578% |
| Prairie States | $617 | 578% |
| Preferred One | $617 | 578% |
| Primary Physician Care | $617 | 578% |
| Professional Benefit Administrators | $617 | 578% |
| Siho Insurance Services | $617 | 578% |
| The Loomis Company | $617 | 578% |
| Unicare | $617 | 578% |
| Us Health And Life | $617 | 578% |
| Valenz | $617 | 578% |
| Western & Southern Financial Group | $617 | 578% |
| Wps | $617 | 578% |
| Cigna | $623 | 583% |
| Coventry | $633 | 593% |
| First Health | $633 | 593% |
| Prime Health Services | $672 | 629% |
| Three Rivers Provider Network | $756 | 708% |
| Cmh Detroit Wayne Integrated Health Network | $840 | 786% |
| Cmh Lenawee County | $840 | 786% |
| Cmh Livingston County | $840 | 786% |
| Cmh Misc | $840 | 786% |
| Cmh Monroe County | $840 | 786% |
| Cmh Oakland County | $840 | 786% |
| Cmh Washtenaw County | $840 | 786% |