CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mt Sinai Hospital Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $307
  • Cash Discount Price: $522
  • vs. Medicare Baseline: 2.87x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mt Sinai Hospital Medical Center is $307. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $522. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.87x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.
Cash / Self-Pay
$522

Average discount available for prompt cash payment at this facility.

Insurance Median
$307

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: $522 (489%)
Insurance Median: $307 (287%)
Cash: $522 (489% of Medicare)
Ins. Median: $307 (287% 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 287% of the Medicare baseline (a markup of 187%). 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 $105 - $632 98%
Cigna $105 - $1,286 98%
Tricare $109 102%
Va Healthnet - All Plans $109 102%
Advocate Physician Prtnrs Mcr $112 105%
Cenpatico Illinicare Dual $112 105%
Cenpatico Illinicare Mcr - All Other Plans $112 105%
Humana $112 - $3,123 105%
Lawndale Christian - All Plans $112 105%
Meridian/Harmony D-Snp - All Plans $112 105%
Nextlevel Hlth Icp Fhp Aca - All Plans $112 105%
UnitedHealthcare $112 - $522 105%
Harmony Behavioral Htlh - All Plans $115 108%
Zing Mcr Adv - All Plans $117 110%
Molina Mcr - All Other Plans $118 110%
Advocate Physician Prtnrs - All Other Plans $123 115%
Ambetter / Centene $123 - $1,044 115%
Aetna $161 - $2,248 151%
Family Health Network Mcaid - All Plans $161 151%
Molina Mcaid $169 158%
Partners In Hlth - All Plans $198 - $398 185%
Healthlink Hmo $248 - $497 232%
Healthlink Ppo - All Other Plans $248 - $497 232%
Compsych Ip/Op Only - All Plans $298 - $597 279%
Hfn Platinum $322 - $646 301%
Multiplan Primary Ntwrk/Phcs - All Other Plans $347 - $696 325%
Hfn Epo $397 - $796 372%
Multiplan Complementary Ntwrk $397 - $796 372%
Hfn Ppo - All Other Plans $437 - $875 409%
Oscar - All Plans $546 - $1,044 511%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 15Th Street at California, Chicago, IL 60608
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals