CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Massac Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $662
Cash Discount Price: $874
vs. Medicare Baseline: 6.20x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Massac Memorial Hospital is $662. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $874. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.20x the Medicare baseline. Located in 28 Chick Street, Po Box 850, Metropolis, IL.

Cash / Self-Pay

$874

Average discount available for prompt cash payment at this facility.

Insurance Median

$662

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: $874 (818%)

Insurance Median: $662 (620%)

Cash: $874 (818% of Medicare)

Ins. Median: $662 (620% 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 620% of the Medicare baseline (a markup of 520%). 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	$246 - $1,022	230%
Blue Cross Blue Shield	$246 - $1,199	230%
Medicaid / KanCare	$246	230%
Molina Ky Mcaid	$246	230%
Chesi Op Only-All Plans	$662	620%
Health Alliance Mcare Adv	$662	620%
Humana	$662	620%
Health Alliance Exchange	$812	760%
Health Alliance-All Other Plans	$812	760%
Prime Health Services-All Plans	$812	760%
Healthlink Hmo	$916	858%
Healthlink Ppo-All Other Plans	$1,027	962%
Cigna	$1,029	963%
UnitedHealthcare	$1,049	982%
Multiplan-All Plans	$1,124	1052%

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 $874.
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 Massac 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.