CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mon Health Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $235
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mon Health Medical Center is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.20x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$215

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $215 (201%)
Insurance Median: $235 (220%)
Cash: $215 (201% of Medicare)
Ins. Median: $235 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
Geha_Plan $22 - $835 21%
Acpn_Plan $50 - $775 47%
Unison_Plan $51 - $76 48%
Aetna $56 - $184 52%
Blue Cross Blue Shield $56 - $511 52%
Gateway_Health_Plan $56 - $76 52%
Health_South_Mountain_View_Plan $56 - $101 52%
Medicare (plans) $56 - $101 52%
Paramount_Elite_Plan $56 - $101 52%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $56 - $689 52%
Uhc_Onenet_Ppo_Plan $56 - $835 52%
Uhc_Options_Ppo_Plan $56 - $801 52%
Uhc_Plan $56 - $775 52%
Umwa_Plan $56 52%
Zelis_Other_Plan $86 - $228 81%
Maryland_Physicians_Care_Plan $93 - $603 87%
Humana $101 - $775 95%
Uhc_Va_Plan $101 95%
Zelis_Group_Health_Plan $101 - $228 95%
Upmc__Plan $105 - $835 98%
Seven_Corners_Plan $112 - $202 105%
The_Health_Plan_Peia_Plan $116 109%
The_Health_Plan_Plan $692 - $740 648%
Cigna $724 - $775 678%
Mon_County_Commission_Plan $724 - $775 678%
Health_Payors_Organization_Plan $741 - $792 694%
Multiplan_Phcs_Plan $765 - $818 716%
Mutual_Of_Omaha_Plan $765 - $818 716%
Three_Rivers_Plan $781 - $835 731%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals