CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Lafayette Regional Health Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $528
  • Cash Discount Price: $1,257
  • vs. Medicare Baseline: 4.94x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Lafayette Regional Health Center is $528. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,257. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.94x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$1,257

Average discount available for prompt cash payment at this facility.

Insurance Median
$528

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: $1,257 (1177%)
Insurance Median: $528 (494%)
Cash: $1,257 (1177% of Medicare)
Ins. Median: $528 (494% 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 494% of the Medicare baseline (a markup of 394%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
United $60 - $565 56%
Healthyblue $61 57%
Aetna $62 - $1,099 58%
Amerigroup $62 58%
Home State Health Plan $62 58%
Medicaid / KanCare $62 58%
Unicare $62 58%
Corvel Corporation $143 - $1,068 134%
Oha Network $144 - $628 135%
Ambetter / Centene $234 219%
Nhc Advantage $239 224%
Universal Healthcare $327 306%
Humana $425 - $540 398%
Blue Cross Blue Shield $477 - $1,257 447%
College Park Family Care Center $540 506%
Oscar $628 588%
Cigna $718 - $897 672%
Wppa Providrs Care Network $942 882%
Multiplan $980 918%
Coventry $1,003 939%
Coventry Kc Mo $1,003 939%
Cco, Inc. $1,068 1000%
Focus Healthcare Mgmt, Inc $1,131 1059%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals