CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Mercy Health Lakeshore Campus
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $458
- Cash Discount Price: $346
- vs. Medicare Baseline: 4.29x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mercy Health Lakeshore Campus is $458. 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 4.29x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$346
Average discount available for prompt cash payment at this facility.
Insurance Median
$458
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: $458 (429%)
Cash: $346 (324% of Medicare)
Ins. Median: $458 (429% 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 429% of the Medicare baseline (a markup of 329%). 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 | $79 - $456 | 74% |
| Medicaid / KanCare | $79 - $80 | 74% |
| Access Health | $93 | 87% |
| Blue Care Network Advantage | $131 | 123% |
| Medicare (plans) | $131 | 123% |
| Aetna | $133 - $424 | 125% |
| Align Senior Care | $133 | 125% |
| Correctional Recovery | $133 | 125% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $150 | 140% |
| Wellpath | $156 | 146% |
| Oscar | $164 | 154% |
| Vitalcore | $178 | 167% |
| UnitedHealthcare | $187 - $480 | 175% |
| Molina Marketplace | $222 | 208% |
| U Of M Health Plan | $238 - $477 | 223% |
| Hospice Of Michigan | $293 | 274% |
| Nomi Health | $298 | 279% |
| Hap | $399 - $489 | 374% |
| Wc Accident Fund | $420 | 393% |
| Wc Advantage | $420 | 393% |
| Wc Aig | $420 | 393% |
| Wc Allied | $420 | 393% |
| Wc Amerisure | $420 | 393% |
| Wc Amtrust | $420 | 393% |
| Wc Asu Risk Mgt | $420 | 393% |
| Wc Berkley Admin | $420 | 393% |
| Wc Broadspire | $420 | 393% |
| Wc Bunch & Associates | $420 | 393% |
| Wc Ccmsi | $420 | 393% |
| Wc Emc Insurance Company | $420 | 393% |
| Wc Esis | $420 | 393% |
| Wc Fcci | $420 | 393% |
| Wc Federated | $420 | 393% |
| Wc Gallagher Bassett | $420 | 393% |
| Wc Genex Care For Ohio | $420 | 393% |
| Wc Guard Insurance Company | $420 | 393% |
| Wc Hartford | $420 | 393% |
| Wc Liberty Mutual | $420 | 393% |
| Wc Meijers | $420 | 393% |
| Wc Michigan | $420 | 393% |
| Wc Mitchell Frankenmuth | $420 | 393% |
| Wc Pma | $420 | 393% |
| Wc Sedgwick | $420 | 393% |
| Wc Sentry | $420 | 393% |
| Wc Travelers | $420 | 393% |
| Wc Tristar | $420 | 393% |
| Wc Walmart | $420 | 393% |
| Wc Zurich | $420 | 393% |
| Geha | $424 - $480 | 397% |
| Meritain | $424 | 397% |
| Asr Health Benefits | $444 | 416% |
| Bcn Domestic | $456 | 427% |
| Blue Benefit Administrators Of Massachusetts | $456 | 427% |
| Blue Care Network | $456 | 427% |
| Blue Distinction Transplant | $456 | 427% |
| Blue Shield - Ca | $456 | 427% |
| Blue Shield - Id (Regence) | $456 | 427% |
| Blue Shield - Ny Highmark Northeastern | $456 | 427% |
| Blue Shield - Ny Highmark Western | $456 | 427% |
| Blue Shield - Pa (Highmark) | $456 | 427% |
| Blue Shield - Wa (Regence) | $456 | 427% |
| Health Choices | $456 - $477 | 427% |
| Kaiser Domestic | $456 | 427% |
| 1199 National Benefit Fund | $458 | 429% |
| Allied National Global Care | $458 | 429% |
| Asrm - Reliance Standard Life Insurance | $458 | 429% |
| Christian Care Ministry | $458 | 429% |
| Dean Health | $458 | 429% |
| Fallon Health | $458 | 429% |
| Family Life Insurance Company | $458 | 429% |
| Ghc Scw | $458 | 429% |
| Group Pension Administrators | $458 | 429% |
| International Benefit Administrators | $458 | 429% |
| Lifetime Benefit Solutions | $458 | 429% |
| Manhattan Life | $458 | 429% |
| Medi Share | $458 | 429% |
| Multiplan | $458 | 429% |
| Mvp | $458 | 429% |
| Pai | $458 | 429% |
| Pan-American Life | $458 | 429% |
| Paramount Hmo | $458 | 429% |
| Phcs | $458 | 429% |
| Trinity Health Share | $458 | 429% |
| Cigna | $463 | 433% |
| Caresource | $476 | 446% |
| Acclaim | $477 | 447% |
| Administrative Concepts | $477 | 447% |
| Allegeant | $477 | 447% |
| Allied Benefit Systems | $477 | 447% |
| Ameriben | $477 | 447% |
| American Family | $477 | 447% |
| American Healthcare Alliance | $477 | 447% |
| American Republic | $477 | 447% |
| Amerihealth | $477 | 447% |
| Aultcare | $477 | 447% |
| Automated Benefit Services | $477 | 447% |
| Auxiant | $477 | 447% |
| Benefit Administrative Systems,Llc | $477 | 447% |
| Boon Chapman | $477 | 447% |
| Cam Administrative Services | $477 | 447% |
| Christian Brother Services | $477 | 447% |
| Christian Brothers Holy Cross | $477 | 447% |
| Claimchoice Adminstrators | $477 | 447% |
| Comprehensive Benefits | $477 | 447% |
| Consociate | $477 | 447% |
| Continental Life Insurance | $477 | 447% |
| Custom Benefit Administrators | $477 | 447% |
| Cypress Benefit Administrators | $477 | 447% |
| Employee Benefit Concepts | $477 | 447% |
| Employee Benefit Management | $477 | 447% |
| Enterprise Group Planning | $477 | 447% |
| Forest County Potawatomi | $477 | 447% |
| Freedom Life Insurance Company | $477 | 447% |
| Group Administrators | $477 | 447% |
| Group Marketing Services | $477 | 447% |
| Guardian | $477 | 447% |
| Health America | $477 | 447% |
| Health Smart | $477 | 447% |
| Healthez | $477 | 447% |
| Healthgram | $477 | 447% |
| Healthscope | $477 | 447% |
| Humana | $477 | 447% |
| Insight | $477 | 447% |
| Intercare | $477 | 447% |
| Jfp Benefit Management | $477 | 447% |
| Jp Farley Corporation | $477 | 447% |
| Key Benefit Administrator | $477 | 447% |
| Liberty Union Life Assurance Co | $477 | 447% |
| Lucent Health | $477 | 447% |
| Luminare Health | $477 | 447% |
| Luminare Health (Detroit) | $477 | 447% |
| Medben | $477 | 447% |
| Medcost | $477 | 447% |
| Medical Mutual | $477 | 447% |
| Mutual Health Services | $477 | 447% |
| Mutual Of Omaha | $477 | 447% |
| Ncas | $477 | 447% |
| Nippon Life Ins | $477 | 447% |
| Nova | $477 | 447% |
| Painters Union Insurance Fund | $477 | 447% |
| Physicians Mutual | $477 | 447% |
| Plumbers Local 98 Insurance Fund | $477 | 447% |
| Prairie States | $477 | 447% |
| Primary Physician Care | $477 | 447% |
| Professional Benefit Administrators | $477 | 447% |
| Secureone Preferred United Plans | $477 | 447% |
| The Loomis Company | $477 | 447% |
| Trustmark Small Business Benefits | $477 | 447% |
| Unicare | $477 | 447% |
| Unified Group Services | $477 | 447% |
| Us Health And Life | $477 | 447% |
| Valenz | $477 | 447% |
| Varipro | $477 - $489 | 447% |
| Western & Southern Financial Group | $477 | 447% |
| Wps | $477 | 447% |
| Priority Health | $480 | 449% |
| First Health | $482 | 451% |