CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Greater El Monte Community Hospital
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $353
- Cash Discount Price: $1,045
- vs. Medicare Baseline: 3.30x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Greater El Monte Community Hospital is $353. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,045. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.30x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$1,045
Average discount available for prompt cash payment at this facility.
Insurance Median
$353
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: $1,045 (978%)
Insurance Median: $353 (330%)
Cash: $1,045 (978% of Medicare)
Ins. Median: $353 (330% 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 330% of the Medicare baseline (a markup of 230%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $19 - $522 | 18% |
| In Custody-Ca Highway Patrol | $20 | 19% |
| Aids Health Foundation | $60 - $132 | 56% |
| Allied Physicians Medical Group | $60 - $314 | 56% |
| Altamed Health Network | $60 - $132 | 56% |
| Avanti | $60 - $161 | 56% |
| Beverly Hospital | $60 - $148 | 56% |
| Brand New Day | $60 - $168 | 56% |
| Emanate Health | $60 - $168 | 56% |
| Health Net Foundation | $60 - $679 | 56% |
| Healthy Way La | $60 | 56% |
| La Care Health Plan | $60 - $575 | 56% |
| Other Non Contracted Medi-Cal Hmo | $60 | 56% |
| State Of California | $60 | 56% |
| Care 1St Medi Cal Hmo Cap Exceptional Care | $75 - $104 | 70% |
| Care First Health Plan | $75 - $104 | 70% |
| Allied Physicians | $86 - $198 | 81% |
| Associated Hispanic Physicians | $86 - $121 | 81% |
| Hollywood Presbyterian Adv Med Mcal | $86 | 81% |
| Hollywood Presbyterian Medpoint Mcal | $86 | 81% |
| Caloptima | $88 | 82% |
| Clinica Medica Familiar | $90 - $522 | 84% |
| Veterans Administration | $94 | 88% |
| Apa/Aco Inc | $132 | 124% |
| Blue Shield Of California | $132 - $606 | 124% |
| Cms | $132 | 124% |
| Easy Choice Health Plan | $132 | 124% |
| Health Net Inc | $132 - $740 | 124% |
| Other Non Contracted Senior Hmo | $132 | 124% |
| Pacific Alliance Medical Center Reciprocal Contract | $132 | 124% |
| Scan Health Plan | $132 | 124% |
| UnitedHealthcare | $132 - $897 | 124% |
| Champus Foundation | $134 | 125% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $134 | 125% |
| Good Samaritan Medical Practice Assoc | $134 - $627 | 125% |
| La Care Covered Direct | $134 | 125% |
| Pacificare Of California | $134 - $905 | 125% |
| Self-Pay | $134 | 125% |
| Alignment Health Plan | $139 | 130% |
| Molina Healthcare | $139 | 130% |
| Inter Valley Health Plan | $141 | 132% |
| Molina Healthcare Of California | $141 - $408 | 132% |
| San Miguel Health Plan | $148 | 139% |
| Bella Vista Medical Group Ipa | $149 - $470 | 140% |
| Employee Health Systems Medical Group | $149 - $209 | 140% |
| Global Care Medical Group Ipa | $149 - $470 | 140% |
| Central Health Plan | $153 - $732 | 143% |
| Chinatown Service Center Pace | $159 | 149% |
| Intercomp | $161 | 151% |
| Ahmc Health Self-Insurance Epo | $168 | 157% |
| Knox-Keene Act | $168 | 157% |
| Preferred Health Network | $170 | 159% |
| Interplan | $173 - $784 | 162% |
| Athens Administrators | $179 | 168% |
| Multiplan | $179 - $888 | 168% |
| Other Non Contracted Work Comp | $179 | 168% |
| Alta Med Health Services Med Grp | $186 - $261 | 174% |
| Ahmc Reciprocity Agreement | $224 - $314 | 210% |
| Ahmc Reciprocity Agreement Senior/Commercial | $224 - $314 | 210% |
| Lincoln Hospital Medical Center | $224 - $314 | 210% |
| Cigna | $241 | 226% |
| California Thoroughbred Horesmans Foundation | $373 - $522 | 349% |
| Universal Care | $373 - $732 | 349% |
| Care 1St Health Plan | $448 - $627 | 419% |
| Cost Containment Strategies | $485 - $679 | 454% |
| In Custody Police Dept | $485 - $679 | 454% |
| Community Care Network | $597 - $836 | 559% |
| Health Payors Organization | $671 - $940 | 628% |
| Commercial Non Contract | $746 - $1,045 | 698% |
| Medi-Cal Sub Acute | $746 - $1,045 | 698% |
| Nuclear Medicine/Whmc | $746 - $1,045 | 698% |
| One Legacy | $746 - $1,045 | 698% |