CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Fayette County Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $215
Cash Discount Price: $727
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Fayette County Hospital is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.01x the Medicare baseline. Located in 650 W Taylor St, Vandalia, IL.

Cash / Self-Pay

$727

Average discount available for prompt cash payment at this facility.

Insurance Median

$215

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: $727 (681%)

Insurance Median: $215 (201%)

Cash: $727 (681% of Medicare)

Ins. Median: $215 (201% 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 201% of the Medicare baseline (a markup of 101%). 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	$24 - $897	22%
Health Alliance Mcare	$26 - $416	24%
Healthlink Mcr Adv	$26 - $416	24%
Cigna	$31 - $975	29%
Coventry/Ghp-All Plans	$36 - $845	34%
Multiplan - All Plans	$49 - $1,105	46%
Health Alliance - All Other Plans	$53 - $1,074	50%
Blue Cross Blue Shield	$63 - $1,092	59%
Illinicare - All Plans	$72 - $215	67%
Medicaid / KanCare	$72 - $215	67%
Meridian-All Plans	$72 - $215	67%
UnitedHealthcare	$128 - $1,079	120%
Healthlink Hmo	$132 - $910	124%
Healthlink Ppo - All Other Plans	$132 - $1,040	124%
Humana	$416	389%

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 $727.
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 Fayette County 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.