CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Trinity Health Muskegon Hospital
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $400
- Cash Discount Price: $346
- vs. Medicare Baseline: 3.74x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Trinity Health Muskegon Hospital is $400. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $346. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.74x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$346
Average discount available for prompt cash payment at this facility.
Insurance Median
$400
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: $346 (324%)
Insurance Median: $400 (374%)
Cash: $346 (324% of Medicare)
Ins. Median: $400 (374% 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 374% of the Medicare baseline (a markup of 274%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $58 - $225 | 54% |
| Medicaid / KanCare | $58 - $60 | 54% |
| Access Health | $78 | 73% |
| Aetna | $109 - $294 | 102% |
| Blue Care Network Advantage | $109 | 102% |
| Medicare (plans) | $109 | 102% |
| Align Senior Care | $112 | 105% |
| Correctional Recovery | $112 | 105% |
| Heartland Hospice | $112 | 105% |
| Hospice Harbor Hospice | $112 | 105% |
| UnitedHealthcare | $115 - $469 | 108% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $126 | 118% |
| Oscar | $143 | 134% |
| Molina Marketplace | $145 | 136% |
| Vitalcore | $173 | 162% |
| Wellpath | $173 | 162% |
| Priority Health | $215 - $391 | 201% |
| Bcn Domestic | $225 | 211% |
| Blue Benefit Administrators Of Massachusetts | $225 | 211% |
| Blue Care Network | $225 | 211% |
| Blue Distinction Transplant | $225 | 211% |
| Blue Shield - Ca | $225 | 211% |
| Blue Shield - Id (Regence) | $225 | 211% |
| Blue Shield - Ny Highmark Northeastern | $225 | 211% |
| Blue Shield - Ny Highmark Western | $225 | 211% |
| Blue Shield - Pa (Highmark) | $225 | 211% |
| Blue Shield - Wa (Regence) | $225 | 211% |
| Health Choices | $225 - $420 | 211% |
| Kaiser Domestic | $225 | 211% |
| U Of M Health Plan | $238 - $420 | 223% |
| Acs Benefit Services | $277 | 259% |
| Allied Benefit Systems | $277 | 259% |
| Claimchoice Adminstrators | $277 | 259% |
| Consociate | $277 | 259% |
| Cypress Benefit Administrators | $277 | 259% |
| Forest County Potawatomi | $277 | 259% |
| Health Smart | $277 | 259% |
| Healthgram | $277 | 259% |
| Healthscope | $277 | 259% |
| Preferred One | $277 | 259% |
| Secureone Preferred United Plans | $277 | 259% |
| Sisco Benefits | $277 | 259% |
| The Health Plan | $277 | 259% |
| Trustmark Small Business Benefits | $277 | 259% |
| Unified Group Services | $277 | 259% |
| Webtpa | $277 | 259% |
| Asr Health Benefits | $283 | 265% |
| Hap | $283 - $422 | 265% |
| Wc Accident Fund | $284 | 266% |
| Wc Advantage | $284 | 266% |
| Wc Aig | $284 | 266% |
| Wc Allied | $284 | 266% |
| Wc Amerisure | $284 | 266% |
| Wc Amtrust | $284 | 266% |
| Wc Asu Risk Mgt | $284 | 266% |
| Wc Berkley Admin | $284 | 266% |
| Wc Broadspire | $284 | 266% |
| Wc Bunch & Associates | $284 | 266% |
| Wc Ccmsi | $284 | 266% |
| Wc Emc Insurance Company | $284 | 266% |
| Wc Esis | $284 | 266% |
| Wc Fcci | $284 | 266% |
| Wc Federated | $284 | 266% |
| Wc Gallagher Bassett | $284 | 266% |
| Wc Genex Care For Ohio | $284 | 266% |
| Wc Guard Insurance Company | $284 | 266% |
| Wc Hartford | $284 | 266% |
| Wc Liberty Mutual | $284 | 266% |
| Wc Meijers | $284 | 266% |
| Wc Michigan | $284 | 266% |
| Wc Mitchell Frankenmuth | $284 | 266% |
| Wc Pma | $284 | 266% |
| Wc Sedgwick | $284 | 266% |
| Wc Sentry | $284 | 266% |
| Wc Travelers | $284 | 266% |
| Wc Tristar | $284 | 266% |
| Wc Walmart | $284 | 266% |
| Wc Zurich | $284 | 266% |
| Hospice Of Michigan | $293 | 274% |
| Geha | $294 - $469 | 275% |
| Meritain | $294 | 275% |
| Nomi Health | $298 | 279% |
| Varipro | $308 | 288% |
| Caresource | $335 | 314% |
| Cigna | $335 | 314% |
| 1199 National Benefit Fund | $400 | 374% |
| Allied National Global Care | $400 | 374% |
| Asrm - Reliance Standard Life Insurance | $400 | 374% |
| Christian Care Ministry | $400 | 374% |
| Dean Health | $400 | 374% |
| Fallon Health | $400 | 374% |
| Family Life Insurance Company | $400 | 374% |
| Ghc Scw | $400 | 374% |
| Group Pension Administrators | $400 | 374% |
| International Benefit Administrators | $400 | 374% |
| Lifetime Benefit Solutions | $400 | 374% |
| Manhattan Life | $400 | 374% |
| Medi Share | $400 | 374% |
| Multiplan | $400 | 374% |
| Mvp | $400 | 374% |
| Pai | $400 | 374% |
| Pan-American Life | $400 | 374% |
| Paramount Hmo | $400 | 374% |
| Phcs | $400 | 374% |
| Trinity Health Share | $400 | 374% |
| Acclaim | $420 | 393% |
| Administrative Concepts | $420 | 393% |
| Allegeant | $420 | 393% |
| Ameriben | $420 | 393% |
| American Family | $420 | 393% |
| American Healthcare Alliance | $420 | 393% |
| American Republic | $420 | 393% |
| Amerihealth | $420 | 393% |
| Aultcare | $420 | 393% |
| Automated Benefit Services | $420 | 393% |
| Auxiant | $420 | 393% |
| Benefit Administrative Systems,Llc | $420 | 393% |
| Boon Chapman | $420 | 393% |
| Cam Administrative Services | $420 | 393% |
| Christian Brother Services | $420 | 393% |
| Christian Brothers Holy Cross | $420 | 393% |
| Comprehensive Benefits | $420 | 393% |
| Continental Life Insurance | $420 | 393% |
| Custom Benefit Administrators | $420 | 393% |
| Employee Benefit Concepts | $420 | 393% |
| Employee Benefit Management | $420 | 393% |
| Enterprise Group Planning | $420 | 393% |
| Freedom Life Insurance Company | $420 | 393% |
| Group Administrators | $420 | 393% |
| Group Marketing Services | $420 | 393% |
| Guardian | $420 | 393% |
| Health America | $420 | 393% |
| Healthez | $420 | 393% |
| Humana | $420 | 393% |
| Insight | $420 | 393% |
| Intercare | $420 | 393% |
| Jfp Benefit Management | $420 | 393% |
| Jp Farley Corporation | $420 | 393% |
| Key Benefit Administrator | $420 | 393% |
| Liberty Union Life Assurance Co | $420 | 393% |
| Lucent Health | $420 | 393% |
| Luminare Health | $420 | 393% |
| Luminare Health (Detroit) | $420 | 393% |
| Medben | $420 | 393% |
| Medcost | $420 | 393% |
| Medical Mutual | $420 | 393% |
| Mutual Health Services | $420 | 393% |
| Mutual Of Omaha | $420 | 393% |
| Ncas | $420 | 393% |
| Nippon Life Ins | $420 | 393% |
| Nova | $420 | 393% |
| Painters Union Insurance Fund | $420 | 393% |
| Physicians Mutual | $420 | 393% |
| Plumbers Local 98 Insurance Fund | $420 | 393% |
| Prairie States | $420 | 393% |
| Primary Physician Care | $420 | 393% |
| Professional Benefit Administrators | $420 | 393% |
| The Loomis Company | $420 | 393% |
| Unicare | $420 | 393% |
| Us Health And Life | $420 | 393% |
| Valenz | $420 | 393% |
| Western & Southern Financial Group | $420 | 393% |
| Wps | $420 | 393% |
| First Health | $437 | 409% |
| Barinet | $533 | 499% |
| Cmh Allegan County | $533 | 499% |
| Cmh Barry County | $533 | 499% |
| Cmh Berrien County | $533 | 499% |
| Cmh Cass County | $533 | 499% |
| Cmh Kalamazoo | $533 | 499% |
| Cmh Kent County | $533 | 499% |
| Cmh Misc | $533 | 499% |
| Cmh Muskegon County | $533 | 499% |
| Cmh North Country | $533 | 499% |
| Cmh Northern Lakes County | $533 | 499% |
| Cmh Ottawa County | $533 | 499% |
| Cmh Van Buren County | $533 | 499% |
| Cmh West Mi County | $533 | 499% |