CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Lovelace Women's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $934
Cash Discount Price: $311
vs. Medicare Baseline: 8.74x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Lovelace Women's Hospital is $934. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $311. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.74x the Medicare baseline. Located in 4701 Montgomery Boulevard Ne, Albuquerque, NM.

Cash / Self-Pay

$311

Average discount available for prompt cash payment at this facility.

Insurance Median

$934

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: $311 (291%)

Insurance Median: $934 (874%)

Cash: $311 (291% of Medicare)

Ins. Median: $934 (874% 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 874% of the Medicare baseline (a markup of 774%). 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
The Health Plan [2915]	$210	197%
UnitedHealthcare	$273	256%
Healthscope Benefits [2290]	$273	256%
Magellan Behavioral Commercial [2895]	$519	486%
Benefit Management [1175]	$519	486%
Presbyterian Health Plan [1830]	$519	486%
Zelis [2385]	$519	486%
Administrative Concepts [1005]	$934	874%
Fmh Benefit Services [1390]	$934	874%
Coventry Healthcare [1320]	$934	874%
Employee Benefit Management Services [2445]	$934	874%
Coresource [1315]	$934	874%
Allied Benefit Systems Inc [1030]	$934	874%
Pan American Life Insurance Co [1770]	$934	874%
PHCS [1780]	$934	874%
Allied National Global Care [1035]	$934	874%
First Health [1375]	$934	874%
Aetna	$934	874%
Emblem Health [2430]	$934	874%
Multiplan [1680]	$934	874%
Mutual of Omaha [1685]	$934	874%
Trustmark [2030]	$934	874%
Northamerica Administrators [1725]	$934	874%
Boon-Chapman [2375]	$934	874%
American Medical Security [2190]	$934	874%
National Telephone Cooperative [1700]	$934	874%
Healthnet [1495]	$934	874%
Healthsmart [1505]	$934 - $965	874%
Kaiser Permanente [1560]	$934	874%
Healthcost Solutions [2415]	$934	874%

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 $311.
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 Lovelace Women's Hospital 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.