CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Palos Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,439
Cash Discount Price: $1,343
vs. Medicare Baseline: 13.47x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Palos Community Hospital is $1,439. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,343. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 13.47x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$1,343

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,439

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: $1,343 (1257%)

Insurance Median: $1,439 (1347%)

Cash: $1,343 (1257% of Medicare)

Ins. Median: $1,439 (1347% 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 1347% of the Medicare baseline (a markup of 1247%). 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
Blue Cross Blue Shield	$307 - $1,919	287%
Aetna	$413 - $1,919	387%
Carelon Behavioral Health [159]	$960	899%
Healthlink [125]	$960 - $1,919	899%
First Health Plan [6034]	$1,090 - $1,439	1021%
Magellan Behavioral Hlth [136]	$1,151	1078%
The Alliance [1703]	$1,233	1154%
Multiplan/Phcs [142]	$1,343 - $1,919	1257%
Compsych [112]	$1,439	1347%
Beechstreet [176]	$1,535	1437%
Cigna	$1,535 - $1,919	1437%
Health'S Finest Network [126]	$1,631	1527%
Galaxy Health Network [220]	$1,919	1797%
Global Excel [1712]	$1,919	1797%
Health Alliance [181]	$1,919	1797%
UnitedHealthcare	$1,919	1797%

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 $1,343.
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 Palos Community 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.