CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Decatur Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $335
Cash Discount Price: $1,377
vs. Medicare Baseline: 3.14x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Decatur Memorial Hospital is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,377. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.14x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.

Cash / Self-Pay

$1,377

Average discount available for prompt cash payment at this facility.

Insurance Median

$335

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: $1,377 (1289%)

Insurance Median: $335 (314%)

Cash: $1,377 (1289% of Medicare)

Ins. Median: $335 (314% 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 314% of the Medicare baseline (a markup of 214%). 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
Aetna	$100 - $924	94%
Blue Cross Blue Shield	$100 - $1,377	94%
Coventry	$100 - $698	94%
Health Alliance	$100 - $916	94%
Humana	$100 - $895	94%
Medicare (plans)	$100 - $110	94%
UnitedHealthcare	$100 - $1,377	94%
Veterans Administration	$100 - $110	94%
Tricare	$102 - $112	95%
Wellcare	$110	103%
Plain Church Medical Group	$136 - $620	127%
Medicaid / KanCare	$137 - $140	128%
Caterpillar	$252	236%
Hfn	$296 - $1,033	277%
Commercial Workers Compensation	$300	281%
Illinois Workers Compensation	$315 - $321	295%
Mennonite Churches	$482	451%
Health Alliance Mh Employee Plan	$633	593%
Cigna	$642	601%
6 Degrees Health	$826	773%
Hopetrust	$826	773%
Hst	$826	773%
Phcs Savility	$895	838%
Phcs Multiplan Ppo	$936	876%
Healthlink	$945	885%
Corvel	$991	928%
Consociate	$1,019	954%
Liability	$1,377	1289%

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 $1,377.
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 Decatur Memorial 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.