CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Francis Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $766
Cash Discount Price: $743
vs. Medicare Baseline: 7.17x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Francis Hospital is $766. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $743. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.17x the Medicare baseline. Located in 1215 Franciscan Dr, Litchfield, IL.

Cash / Self-Pay

$743

Average discount available for prompt cash payment at this facility.

Insurance Median

$766

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: $743 (696%)

Insurance Median: $766 (717%)

Cash: $743 (696% of Medicare)

Ins. Median: $766 (717% 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 717% of the Medicare baseline (a markup of 617%). 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
Wexford	$68 - $136	64%
Molina Healthcare	$71 - $228	66%
Meridian Health Plan	$75 - $149	70%
Humana	$217	203%
Blue Cross Blue Shield	$217 - $237	203%
Clear Spring Health of Illinois	$217	203%
UnitedHealthcare	$227 - $1,032	213%
Aetna	$227 - $726	213%
Amish Community	$289	271%
Celtic Insurance Company	$522	489%
Claim Doc	$542	507%
Hopetrust	$593	555%
Wellfirst	$664	622%
First Health	$766	717%
Caterpillar, Inc.	$828	775%
Current Health Solutions	$867	812%
Multiplan/Phcs	$877	821%
Consociate Group	$877	821%
Healthlink	$880	824%
Cigna	$918	859%
Healthcare Finest Network (Hfn)	$929	870%
Provider Network of America	$929	870%
Live360	$1,032	966%
Illinois Breast and Cervical Cancer Program	$1,032	966%
Interplan	$1,032	966%
Naphcare	$1,032	966%
Health Alliance Medical Plans	$1,032	966%
Healthscope	$1,032	966%

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 $743.
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 St Francis 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.