CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Sanford Thief River Falls Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $419
Cash Discount Price: $507
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Sanford Thief River Falls Medical Center is $419. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $507. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.92x the Medicare baseline. Located in 3001 Sanford Parkway, Thief River Falls, MN.

Cash / Self-Pay

$507

Average discount available for prompt cash payment at this facility.

Insurance Median

$419

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: $507 (475%)

Insurance Median: $419 (392%)

Cash: $507 (475% of Medicare)

Ins. Median: $419 (392% 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 392% of the Medicare baseline (a markup of 292%). 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
Primewest	$112 - $266	105%
Ucare	$112 - $557	105%
Blue Cross Blue Shield	$218 - $438	204%
Sanford Health Plan Align	$241	226%
Aetna	$261 - $551	244%
Health Partners	$261 - $514	244%
Medicare (plans)	$261	244%
UnitedHealthcare	$261 - $529	244%
Sanford Health Plan	$340 - $400	318%
Security Health Plan	$349	327%
Medica	$557 - $600	521%
Cigna	$571	535%
First Choice Health Network	$571	535%
Healthez	$571	535%
Multiplan	$571	535%

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 $507.
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 Sanford Thief River Falls Medical Center 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.