CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Joseph's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $821
  • Cash Discount Price: $985
  • vs. Medicare Baseline: 7.69x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Joseph's Hospital is $821. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $985. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.69x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$985

Average discount available for prompt cash payment at this facility.

Insurance Median
$821

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: $985 (922%)
Insurance Median: $821 (769%)
Cash: $985 (922% of Medicare)
Ins. Median: $821 (769% 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 769% of the Medicare baseline (a markup of 669%). 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
Molina Healthcare $110 - $274 103%
Meridian Health Plan $115 - $231 108%
Cigna $245 229%
Humana $274 257%
UnitedHealthcare $274 - $1,368 257%
Sae Hospice $274 257%
Clear Spring Health of Illinois $274 257%
Aetna $274 - $956 257%
Blue Cross Blue Shield $274 257%
Amish Community $383 359%
Naphcare $575 538%
Celtic Insurance Company $602 564%
Claim Doc $684 640%
Hopetrust $684 640%
Caterpillar, Inc. $742 695%
Wellfirst $876 820%
First Health $1,011 947%
Healthlink $1,163 1089%
Multiplan/Phcs $1,163 1089%
Healthcare Finest Network (Hfn) $1,231 1153%
Provider Network of America $1,231 1153%
Health Alliance Medical Plans $1,368 1281%
Illinois Breast and Cervical Cancer Program $1,368 1281%
Healthscope $1,368 1281%
Current Health Solutions $1,368 1281%
Interplan $1,368 1281%
Consociate Group $1,368 1281%
Mental Health Network $1,368 1281%
Qtc Medical Group of Illinois $1,368 1281%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals