CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Hamilton Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $378
  • Cash Discount Price: $419
  • vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Hamilton Memorial Hospital is $378. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $419. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.54x the Medicare baseline. Located in 611 S Marshall Avenue, McLeansboro, IL.
Cash / Self-Pay
$419

Average discount available for prompt cash payment at this facility.

Insurance Median
$378

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: $419 (392%)
Insurance Median: $378 (354%)
Cash: $419 (392% of Medicare)
Ins. Median: $378 (354% 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 354% of the Medicare baseline (a markup of 254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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 $102 - $443 95%
Blue Cross Blue Shield $102 - $448 95%
Health Alliance $102 - $394 95%
Medicare (plans) $102 - $197 95%
UnitedHealthcare $102 - $353 95%
Wellcare $102 - $197 95%
Medicaid / KanCare $183 - $197 171%
Humana $197 184%
Alliance Coal $345 323%
Healthscope $345 323%
Wellfirst (Ssmhic) $345 323%
Hope Trust $369 345%
Cigna $387 362%
Hfn, Inc $394 - $443 369%
Healthlink $419 - $443 392%
Multiplan $419 392%
Siho $443 415%
Three Rivers Provider $443 415%
Healthsmart $468 438%
Stratose $468 438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 611 S Marshall Avenue, McLeansboro, IL 62859
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals