CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: McLaren Macomb

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $59
Cash Discount Price: $235
vs. Medicare Baseline: 0.55x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at McLaren Macomb is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $235. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.55x the Medicare baseline. Located in 1000 Harrington St, Mount Clemens, MI.

Cash / Self-Pay

$235

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $235 (220%)

Insurance Median: $59 (55%)

Cash: $235 (220% of Medicare)

Ins. Median: $59 (55% 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
Medicaid / KanCare	$17 - $61	16%
Mclaren Commercial Ins	$21 - $249	20%
Humana	$26 - $104	24%
Medicare (plans)	$26 - $166	24%
U Of M Health Plan	$30	28%
Aetna	$32 - $535	30%
UnitedHealthcare	$33 - $585	31%
Priority Health	$39 - $486	37%
Blue Cross Blue Shield	$43 - $543	40%
Tricare	$94	88%
Mi Amish Medical Board	$104	97%
Workers Compensation	$283	265%
Cofinity Group 15892 & 15893	$450	421%

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 $235.
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 McLaren Macomb 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.