CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Saint Joseph Hospital-Elgin

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $111
Cash Discount Price: $111
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Saint Joseph Hospital-Elgin is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.04x the Medicare baseline. Located in 77 N Airlite Street, Elgin, IL.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $111 (104%)

Insurance Median: $111 (104%)

Cash: $111 (104% of Medicare)

Ins. Median: $111 (104% 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
Ravenswood Physicians Associates Ipa	$85 - $111	80%
Resurrection Physicians Provider Group Ipa	$85 - $111	80%
Cigna	$93 - $775	87%
Aetna	$95 - $117	89%
Blue Cross Blue Shield	$95 - $156	89%
Humana	$95 - $123	89%
Medicaid / KanCare	$95 - $100	89%
Meridian	$100 - $117	94%
Molina	$100 - $167	94%
Celtic (Wellcare)	$111	104%
Clear Spring Health Of Illinois	$111	104%
Devoted Health	$111	104%
Essential Health Partners	$111 - $128	104%
Longevity Health Plan Of Illinois	$111	104%
Medicare (plans)	$111	104%
Self-Pay	$111	104%
Tricare	$111	104%
United Behavioral	$111	104%
UnitedHealthcare	$111 - $246	104%
Zing Health Provider Network	$115	108%
Providers Partners Health Plan (Pphp)	$117	110%
Harmony Health Plan	$118	110%
Access Community Health Network	$134	125%
Clifton Health Systems	$173	162%
Ambetter / Centene	$181	169%
Hfn Inc	$513	480%
Coventry	$524	491%
Workers Comp	$524	491%

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 $111.
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 Saint Joseph Hospital-Elgin 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.