CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mercy Hospital Carthage

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $402
Cash Discount Price: $476
vs. Medicare Baseline: 3.76x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mercy Hospital Carthage is $402. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $476. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.76x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.

Cash / Self-Pay

$476

Average discount available for prompt cash payment at this facility.

Insurance Median

$402

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: $476 (446%)

Insurance Median: $402 (376%)

Cash: $476 (446% of Medicare)

Ins. Median: $402 (376% 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 376% of the Medicare baseline (a markup of 276%). 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	$60 - $292	56%
Medicaid / KanCare	$60 - $402	56%
Aetna	$70 - $651	66%
Humana	$70 - $220	66%
United Medical Resources Contracted [320454]	$96 - $659	90%
UnitedHealthcare	$96 - $637	90%
Medicare (plans)	$100 - $217	94%
Cherokee Nation Health Serv Contracted [320066]	$201	188%
Cigna	$201 - $659	188%
Cross Timbers Hospice [20098]	$201	188%
Dept Of Veteran Affairs Contracted [320106]	$201	188%
Elara Caring Aspire Hospice [20433]	$201	188%
Globalhealth Contracted [320145]	$201	188%
Halo Hcr Inc Hospice Contracted [320432]	$201	188%
Halo Hcr Inc Hospice [20432]	$201	188%
Indian Health Service Contracted [320198]	$201	188%
Kindful Hospice Contracted [320434]	$201	188%
Kindful Hospice [20434]	$201	188%
Medical Associates Health Contracted [320444]	$201	188%
Mercy Hospice Okc [20252]	$201	188%
Mercy Mgd Behavioral Health Contracted [320259]	$201	188%
Pace Of The Ozarks Contracted [320518]	$201	188%
Provider Partners Health Plans Contracted [320450]	$201	188%
Qual Choice Contracted [320325]	$201	188%
Tricare	$202	189%
Point C Contracted [320238]	$256 - $659	240%
Health Systems Inc Contracted [320174]	$315	295%
Insurance System Inc Contracted [320465]	$315	295%
Administrative Payor Contracted [320005]	$329	308%
Centivo Contracted [320505]	$337	316%
Healthscope Contracted [320182]	$381	357%
Ambetter / Centene	$402	376%
Home State Health Plan Contracted [320187]	$402	376%
Novasys Contracted [320285]	$402	376%
Benefit Management Contracted [320052]	$439 - $637	411%
Auxiant Contracted [320462]	$476 - $622	446%
Healthlink Contracted [320179]	$476 - $681	446%
Preferred Health Plan Contracted [320522]	$476	446%
Workers Comp [20426]	$586 - $732	549%
90 Degree Benefits Contracted [320436]	$622	582%
Aither Health Contracted [320449]	$622	582%
Ebms Contracted [320493]	$622	582%
Edison Health Solutions Contracted [320502]	$622	582%
Imagine 360 Contracted [320494]	$622	582%
Mercy Benefit Admin Contracted [320251]	$622 - $659	582%
Reflect Health Contracted [320492]	$622	582%
Show-Me Health Administrators Contracted [320483]	$622	582%
Yuzu Health Contracted [320521]	$622	582%
Medica Contracted [320239]	$634	594%
Evolutions Health Care Contracted [320124]	$637	596%
First Health Contracted [320128]	$637	596%
Multiplan Contracted [320270]	$637	596%
Private Health Care Systems Contracted [320320]	$637	596%
American Healthcare Alliance Contracted [320020]	$659	617%
Ppo Plus Contracted [320310]	$659	617%
Usa Managed Care Org Contracted [320429]	$659	617%

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 $476.
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 Mercy Hospital Carthage 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.