CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mc Donough District Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $139
Cash Discount Price: $392
vs. Medicare Baseline: 1.30x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mc Donough District Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $392. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.30x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.

Cash / Self-Pay

$392

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $392 (367%)

Insurance Median: $139 (130%)

Cash: $392 (367% of Medicare)

Ins. Median: $139 (130% 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.

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
Health Alliance	$15 - $1,019	14%
Hfn	$24 - $1,030	22%
UnitedHealthcare	$24 - $1,030	22%
Aetna	$26 - $1,145	24%
Humana	$26 - $1,030	24%
Medicaid / KanCare	$26 - $1,145	24%
Medicare (plans)	$26 - $119	24%
Meridian	$26 - $119	24%
Molina	$26 - $1,145	24%
Mutual Medical	$26 - $1,145	24%
Veteran Affairs	$26 - $119	24%
Tricare	$111	104%
Springfield Health	$134 - $939	125%
Blue Cross Blue Shield	$137 - $1,145	128%
Consociate	$139 - $973	130%
Trilogy	$139 - $973	130%
Blue Choice	$147 - $1,030	138%
Current Health	$147 - $1,030	138%
Healthlink	$147 - $1,076	138%
Preferred Plan	$155 - $1,088	145%

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 $392.
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 Mc Donough District 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.