CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Kirby Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $127
Cash Discount Price: $414
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Kirby Medical Center is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $414. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.19x the Medicare baseline. Located in 1000 Medical Center Drive, Monticello, IL.

Cash / Self-Pay

$414

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $414 (388%)

Insurance Median: $127 (119%)

Cash: $414 (388% of Medicare)

Ins. Median: $127 (119% 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
Blue Cross Blue Shield	$21 - $1,078	20%
UnitedHealthcare	$25 - $758	23%
Aetna	$26 - $770	24%
Meridian	$26 - $341	24%
Wellcare	$26 - $341	24%
Molina	$27 - $351	25%
Zelis (Hfn)	$33 - $990	31%
Catepillar, Inc.	$53 - $935	50%
Humana	$103 - $825	96%
Healthlink	$244 - $990	228%
Multiplan/Phcs	$244 - $1,045	228%
Cigna	$880	824%

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 $414.
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 Kirby Medical Center 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.