CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $104
Cash Discount Price: $618
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Munson Healthcare Otsego Memorial Hospital is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $618. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.97x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$618

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $618 (579%)

Insurance Median: $104 (97%)

Cash: $618 (579% of Medicare)

Ins. Median: $104 (97% 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.

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
Blue Cross Blue Shield	$17 - $454	16%
Mclaren Health Plan	$17 - $610	16%
Meridian	$17 - $54	16%
Molina	$17 - $112	16%
Priority Health	$17 - $288	16%
UnitedHealthcare	$17 - $582	16%
Aetna	$26 - $589	24%
Blue Care Network	$26 - $104	24%
Hap (Health Alliance Plan)	$26 - $582	24%
Humana	$26 - $104	24%
Medicare (plans)	$26 - $104	24%
Michigan Amish Medical Board	$26 - $104	24%
Northern Michigan Mennonite Group	$26 - $104	24%
Asr Physicians Care Network	$39 - $582	37%
Cigna	$40 - $288	37%
Nomi Health	$41 - $582	38%
Employee Benefit Logistics	$44 - $177	41%
Hospice Of Michigan	$436	408%
Munson Hospice	$509 - $852	477%
Enterprise Group Planning/Employee Benefit Plan	$582	545%
Cofinity	$618	579%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$618	579%
Three Rivers Provider Network	$618	579%

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 $618.
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 Munson Healthcare Otsego Memorial Hospital 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.