CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $160
- Cash Discount Price: $346
- vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Saint Alphonsus Medical Center Ontario is $160. 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 1.50x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$346
Average discount available for prompt cash payment at this facility.
Insurance Median
$160
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: $160 (150%)
Cash: $346 (324% of Medicare)
Ins. Median: $160 (150% 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.
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 |
|---|---|---|
| Medicaid / KanCare | $84 - $160 | 79% |
| Blue Cross Blue Shield | $122 - $452 | 114% |
| Medicare (plans) | $122 - $131 | 114% |
| UnitedHealthcare | $122 - $511 | 114% |
| Aetna | $126 - $504 | 118% |
| American Health Advantage Of Idaho | $127 | 119% |
| Ada County Jail Inmate Ins | $160 | 150% |
| Ambetter / Centene | $160 | 150% |
| Amish Mennonite | $160 | 150% |
| Bcccp-Michigan | $160 | 150% |
| Bccp | $160 | 150% |
| Bmc Healthnet | $160 | 150% |
| Breast Grant-Connecticut | $160 | 150% |
| California Health And Wellness | $160 | 150% |
| Cardinal Innovations Lme | $160 | 150% |
| Care Oregon Ohp | $160 | 150% |
| Cencal Health Plan | $160 | 150% |
| Cenpatico | $160 | 150% |
| Centurion Of Idaho | $160 | 150% |
| Chhuny | $160 | 150% |
| Childrens Comm Health Plan | $160 | 150% |
| Childrens Medical Services Title 19 | $160 | 150% |
| Cigna | $160 - $500 | 150% |
| Community Benefit Health | $160 | 150% |
| Community Care Behavorial Health | $160 | 150% |
| Community Health Choice | $160 | 150% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $160 | 150% |
| Dean Wi Badgercare | $160 | 150% |
| Delaware First Health | $160 | 150% |
| Delta Dental Nj | $160 | 150% |
| Dph Tb Program | $160 | 150% |
| Dscc | $160 | 150% |
| Eastpointe Lme | $160 | 150% |
| Family Health Network | $160 | 150% |
| Freedom First Healthcare | $160 | 150% |
| Ghc Scw Wi Badgercare | $160 | 150% |
| Harbor Health | $160 | 150% |
| Health Safety Net | $160 | 150% |
| Healthy Blue Ne | $160 | 150% |
| Hennepin Health | $160 | 150% |
| Humana | $160 - $468 | 150% |
| Id County Ada | $160 | 150% |
| Id County Canyon | $160 | 150% |
| Id County Cat Fund | $160 | 150% |
| Id County Payette | $160 | 150% |
| Idaho Womens Health Check | $160 | 150% |
| Indiana Breast Cervical Cancer | $160 | 150% |
| Inland Empire Health Plan | $160 | 150% |
| Intercommunity Health Ohp | $160 | 150% |
| Iowa Total Care | $160 | 150% |
| Jai Medical System | $160 | 150% |
| Kern Family Health Plan | $160 | 150% |
| Keystone First | $160 | 150% |
| Keystone First Chip | $160 | 150% |
| La Care Health Plan | $160 | 150% |
| Lakeland Care Inc | $160 | 150% |
| Managed Health Services - Indiana | $160 | 150% |
| Maryland Breast & Cervical Program | $160 | 150% |
| Maryland Healthy Smiles - Scion Dental | $160 | 150% |
| Maryland Physicians Care | $160 | 150% |
| Massachusetts Behavioral Health Partnership | $160 | 150% |
| Mdwise | $160 | 150% |
| Medi-Cal | $160 | 150% |
| Medi-Cal Healthnet | $160 | 150% |
| Medstar Dc Healthy Family | $160 | 150% |
| Medstar Md Health Choice | $160 | 150% |
| Mo Home State Health Plan | $160 | 150% |
| Molina Centennial Care | $160 | 150% |
| Nascentia Health Options | $160 | 150% |
| Nebraska Total Care | $160 | 150% |
| New York Cancer Services Program | $160 | 150% |
| Nextlevel Health | $160 | 150% |
| Oregon Screenwise | $160 | 150% |
| Pace Of Southwest Michigan | $160 | 150% |
| Paramount Advantage | $160 | 150% |
| Parkland Community Health Plan | $160 | 150% |
| Partners Behavioral Lme | $160 | 150% |
| Peach State Healthplan | $160 | 150% |
| Presbyterian Centennial Care | $160 | 150% |
| Prestige Health Choice | $160 | 150% |
| Priority Partners | $160 | 150% |
| Rx 340B Pass Along | $160 | 150% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $160 | 150% |
| Rx Medi-Cal | $160 | 150% |
| Rx Meridian Rx | $160 | 150% |
| Sandhills Center Lme | $160 | 150% |
| Screening For Life | $160 | 150% |
| Sunshine State Health Plan | $160 | 150% |
| Superior Health | $160 | 150% |
| Tenncare | $160 | 150% |
| Texas Children'S Health Plan | $160 | 150% |
| Trillium Community Ohp | $160 | 150% |
| Tufts Health Public Plans | $160 | 150% |
| Vaya Health Lme | $160 | 150% |
| Wellsense Health Plan | $160 | 150% |
| Wi Womens Wellness | $160 | 150% |
| Pacificsource Health Plans | $226 - $500 | 212% |
| Moda Health | $242 - $516 | 227% |
| Blue Benefit Administrators Of Massachusetts | $312 | 292% |
| Blue Care Network | $312 | 292% |
| Blue Distinction Transplant | $312 | 292% |
| Blue Shield - Ca | $312 | 292% |
| Blue Shield - Id (Regence) | $312 | 292% |
| Blue Shield - Ny Highmark Northeastern | $312 | 292% |
| Blue Shield - Ny Highmark Western | $312 | 292% |
| Blue Shield - Pa (Highmark) | $312 | 292% |
| Blue Shield - Wa (Regence) | $312 | 292% |
| Selecthealth | $317 - $479 | 297% |
| Mountain Health Co-Op | $319 | 299% |
| Healthcare Management Admin | $321 | 301% |
| Webtpa | $329 - $479 | 308% |
| Allegiance | $404 | 378% |
| Correctional Health Partners | $415 | 389% |
| Columbia Health Network | $426 | 399% |
| Healthnet | $447 | 419% |
| Allied National Global Care | $479 | 448% |
| Asrm - Reliance Standard Life Insurance | $479 | 448% |
| Christian Care Ministry | $479 | 448% |
| Dean Health | $479 | 448% |
| Fallon Health | $479 | 448% |
| Family Life Insurance Company | $479 | 448% |
| First Choice Health | $479 | 448% |
| Ghc Scw | $479 | 448% |
| International Benefit Administrators | $479 | 448% |
| Lifetime Benefit Solutions | $479 | 448% |
| Manhattan Life | $479 | 448% |
| Pai | $479 | 448% |
| Pan-American Life | $479 | 448% |
| Paramount Hmo | $479 | 448% |
| Phcs | $479 | 448% |
| Trinity Health Share | $479 | 448% |
| Lifewise | $495 | 463% |
| Priority Health | $500 | 468% |
| Allied Benefit Systems | $504 | 472% |
| Ameriben | $504 | 472% |
| Asr Health Benefits | $504 | 472% |
| Christian Brother Services | $504 | 472% |
| Geha | $504 - $511 | 472% |
| Healthez | $504 | 472% |
| Luminare Health (Detroit) | $504 | 472% |
| Rural Carrier Health Benefit Plan | $504 | 472% |
| First Health | $505 | 473% |
| Medi Share | $505 | 473% |
| Providence | $505 | 473% |