CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Matagorda Regional Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $406
Cash Discount Price: $359
vs. Medicare Baseline: 3.80x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Matagorda Regional Medical Center is $406. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.80x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$406

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: $359 (336%)

Insurance Median: $406 (380%)

Cash: $359 (336% of Medicare)

Ins. Median: $406 (380% 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 380% of the Medicare baseline (a markup of 280%). 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
Aetna	$105 - $455	98%
Humana	$105 - $471	98%
Medicare (plans)	$105	98%
Triwest	$105	98%
United	$105	98%
Wellcare	$105	98%
UnitedHealthcare	$116 - $502	109%
Am Better	$127	119%
Alliance	$148	139%
Corvel	$211	198%
Blue Cross Blue Shield	$245 - $490	229%
Comm Care	$398 - $406	373%
Medicaid / KanCare	$398 - $406	373%
Molina	$398 - $406	373%
Scott & White	$398 - $406	373%
Superior	$398 - $406	373%
Tcstar	$398 - $406	373%
Wellpoint	$398 - $406	373%
Coventry First Health	$497 - $508	465%
Galaxy Health	$497 - $508	465%
Cigna	$532 - $544	498%
Independent Medical System	$604 - $616	565%
Multiplan Phcs	$604 - $616	565%
Three Rivers	$604 - $616	565%
Health Smart	$639 - $652	598%
Usa Managed	$639 - $652	598%

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 $359.
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 Matagorda Regional 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.