CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Perham Health

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $296
Cash Discount Price: $535
vs. Medicare Baseline: 2.77x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Perham Health is $296. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $535. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.77x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$535

Average discount available for prompt cash payment at this facility.

Insurance Median

$296

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: $535 (501%)

Insurance Median: $296 (277%)

Cash: $535 (501% of Medicare)

Ins. Median: $296 (277% 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 277% of the Medicare baseline (a markup of 177%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$228 - $557	213%
Health Partners Mcr Adv	$280	262%
Humana	$280	262%
Medica Mcr Adv	$280	262%
Medicare (plans)	$280 - $311	262%
Ucare Mn Senior Health Options	$280	262%
UnitedHealthcare	$288 - $642	270%
Ucare Mn Special Needs Basic Care Dual	$294	275%
Ucare Mn Medical Assistance	$296	277%
Ucare Mn Minnesota Care	$296	277%
Ucare Mn Senior Care Plus	$296	277%
Ucare Mn Special Needs Basic Care	$296	277%
Medicaid / KanCare	$297	278%
Medica Mcaid Mn Care	$301	282%
Medica Mn (Msho)	$339	317%
Ucare Individual And Family Plan-All Other Plans	$341	319%
Medica Mn Senior Hp/Outside Mn	$374	350%
Health Partners Minnesota Care	$412	386%
Medica Commercial-All Other Plans	$602	564%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$617	578%
Health Partners-All Plans	$675	632%
Preferred One (Ppo)	$700	655%
Sanford Health Plan-All Plans	$700	655%

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 $535.
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 Perham Health 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.