CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Anderson Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $598
Cash Discount Price: $643
vs. Medicare Baseline: 5.60x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Anderson Hospital is $598. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $643. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.60x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.

Cash / Self-Pay

$643

Average discount available for prompt cash payment at this facility.

Insurance Median

$598

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: $643 (602%)

Insurance Median: $598 (560%)

Cash: $643 (602% of Medicare)

Ins. Median: $598 (560% 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 560% of the Medicare baseline (a markup of 460%). 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
Health Care Service Corporation	$96 - $588	90%
Tricare	$99 - $4,572	93%
Humana	$102 - $4,767	95%
Medicare (plans)	$102 - $4,767	95%
UnitedHealthcare	$102 - $4,767	95%
Aetna	$110 - $4,767	103%
Devoted Health Ppo	$112 - $4,863	105%
Essence	$112 - $5,010	105%
Clear Springs Health	$114 - $4,910	107%
Medicaid / KanCare	$137 - $176	128%
Ambetter / Centene	$162 - $7,053	152%
Blue Choice	$162 - $7,053	152%
Work Comp	$236 - $26,600	221%
Hopetrust	$280 - $12,160	262%
Self Pay	$643 - $25,000	602%
Blue Cross Blue Shield	$690 - $715	646%
Healthlink	$772	723%
Mercy Aco	$836	783%
Mercy Benefit Admin	$836	783%
Cigna	$900	843%
Multiplan/Phcs	$965	903%
Beech Street Corporation	$1,158	1084%

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 $643.
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 Anderson 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.