CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Rochelle Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $732
Cash Discount Price: $945
vs. Medicare Baseline: 6.85x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Rochelle Community Hospital is $732. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $945. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.85x the Medicare baseline. Located in 900 N 2Nd St, Rochelle, IL.

Cash / Self-Pay

$945

Average discount available for prompt cash payment at this facility.

Insurance Median

$732

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: $945 (885%)

Insurance Median: $732 (685%)

Cash: $945 (885% of Medicare)

Ins. Median: $732 (685% 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 685% of the Medicare baseline (a markup of 585%). 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	$189 - $472	177%
Blue Cross Blue Shield	$189 - $945	177%
Medicaid / KanCare	$189	177%
Health Alliance Mcr Adv	$331	310%
Humana	$331 - $756	310%
UnitedHealthcare	$331 - $850	310%
Va Ccn - All Plans	$331	310%
Wellcare Mcr Adv - All Plans	$337	316%
Cigna	$709	664%
Osf Dan Ppo - All Plans	$709	664%
Beech Street-All Plans	$756	708%
First Health - All Plans	$756	708%
Health Alliance-All Other Plans	$756	708%
Ecoh-All Plans	$803	752%
Hfn-All Plans	$803	752%
The Alliance-All Plans	$803	752%
Quartz Health Solutions-All Plans	$832	779%
Multiplan-All Plans	$888	831%

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 $945.
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 Rochelle Community 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.