CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $530
- Cash Discount Price: $546
- vs. Medicare Baseline: 4.96x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Joe Mercy Hospital System Livonia is $530. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $546. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.96x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$546
Average discount available for prompt cash payment at this facility.
Insurance Median
$530
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: $546 (511%)
Insurance Median: $530 (496%)
Cash: $546 (511% of Medicare)
Ins. Median: $530 (496% 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 496% of the Medicare baseline (a markup of 396%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $57 - $58 | 53% |
| Blue Cross Blue Shield | $58 - $163 | 54% |
| Aetna | $102 - $369 | 95% |
| Blue Care Network Advantage | $102 | 95% |
| Hospice Of Michigan | $102 | 95% |
| Medicare (plans) | $102 - $109 | 95% |
| Align Senior Care | $104 | 97% |
| Angela Hospice | $104 | 97% |
| UnitedHealthcare | $107 - $538 | 100% |
| Cca - Zing Health | $110 | 103% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $117 | 110% |
| Molina Marketplace | $135 | 126% |
| Priority Health | $157 - $175 | 147% |
| Health Cost Solutions | $162 | 152% |
| Vitalcore | $162 | 152% |
| Wellpath | $162 | 152% |
| Bcn Domestic | $163 | 153% |
| Blue Benefit Administrators Of Massachusetts | $163 | 153% |
| Blue Care Network | $163 | 153% |
| Blue Distinction Transplant | $163 | 153% |
| Blue Shield - Ca | $163 | 153% |
| Blue Shield - Id (Regence) | $163 | 153% |
| Blue Shield - Ny Highmark Northeastern | $163 | 153% |
| Blue Shield - Ny Highmark Western | $163 | 153% |
| Blue Shield - Pa (Highmark) | $163 | 153% |
| Blue Shield - Wa (Regence) | $163 | 153% |
| Health Choices | $163 - $533 | 153% |
| Kaiser Domestic | $163 | 153% |
| Asr Health Benefits | $220 | 206% |
| Caresource | $220 | 206% |
| Hap | $220 - $515 | 206% |
| Varipro | $220 | 206% |
| Employee Benefit Logistic | $234 | 219% |
| Wc Accident Fund | $237 | 222% |
| Wc Advantage | $237 | 222% |
| Wc Aig | $237 | 222% |
| Wc Allied | $237 | 222% |
| Wc Amerisure | $237 | 222% |
| Wc Amtrust | $237 | 222% |
| Wc Asu Risk Mgt | $237 | 222% |
| Wc Berkley Admin | $237 | 222% |
| Wc Broadspire | $237 | 222% |
| Wc Bunch & Associates | $237 | 222% |
| Wc Ccmsi | $237 | 222% |
| Wc Emc Insurance Company | $237 | 222% |
| Wc Esis | $237 | 222% |
| Wc Fcci | $237 | 222% |
| Wc Federated | $237 | 222% |
| Wc Gallagher Bassett | $237 | 222% |
| Wc Genex Care For Ohio | $237 | 222% |
| Wc Guard Insurance Company | $237 | 222% |
| Wc Hartford | $237 | 222% |
| Wc Liberty Mutual | $237 | 222% |
| Wc Meijers | $237 | 222% |
| Wc Michigan | $237 | 222% |
| Wc Mitchell Frankenmuth | $237 | 222% |
| Wc Pma | $237 | 222% |
| Wc Sedgwick | $237 | 222% |
| Wc Sentry | $237 | 222% |
| Wc Travelers | $237 | 222% |
| Wc Tristar | $237 | 222% |
| Wc Walmart | $237 | 222% |
| Wc Zurich | $237 | 222% |
| U Of M Health Plan | $238 | 223% |
| Geha | $294 - $538 | 275% |
| Luminare Health (Detroit) | $294 | 275% |
| Meritain | $294 | 275% |
| Acs Benefit Services | $359 | 336% |
| Allied Benefit Systems | $359 | 336% |
| Claimchoice Adminstrators | $359 | 336% |
| Consociate | $359 | 336% |
| Cypress Benefit Administrators | $359 | 336% |
| Forest County Potawatomi | $359 | 336% |
| Health Smart | $359 | 336% |
| Healthgram | $359 | 336% |
| Healthscope | $359 | 336% |
| Secureone Preferred United Plans | $359 | 336% |
| Sisco Benefits | $359 | 336% |
| The Health Plan | $359 | 336% |
| Trustmark Small Business Benefits | $359 | 336% |
| Unified Group Services | $359 | 336% |
| Webtpa | $359 | 336% |
| Health Partners | $515 | 482% |
| Tufts Health Plan | $515 | 482% |
| Cigna | $526 - $672 | 492% |
| Access Health | $533 | 499% |
| Acclaim | $533 | 499% |
| Administrative Concepts | $533 | 499% |
| Allegeant | $533 | 499% |
| Ameriben | $533 | 499% |
| American Family | $533 | 499% |
| American Healthcare Alliance | $533 | 499% |
| American National | $533 | 499% |
| American Republic | $533 | 499% |
| Amerihealth | $533 | 499% |
| Aultcare | $533 | 499% |
| Automated Benefit Services | $533 | 499% |
| Auxiant | $533 | 499% |
| Benefit Administrative Systems,Llc | $533 | 499% |
| Boon Chapman | $533 | 499% |
| Cam Administrative Services | $533 | 499% |
| Christian Brother Services | $533 | 499% |
| Christian Brothers Holy Cross | $533 | 499% |
| Comprehensive Benefits | $533 | 499% |
| Continental Life Insurance | $533 | 499% |
| Custom Benefit Administrators | $533 | 499% |
| Employee Benefit Concepts | $533 | 499% |
| Employee Benefit Management | $533 | 499% |
| Enterprise Group Planning | $533 | 499% |
| Freedom Life Insurance Company | $533 | 499% |
| Group Administrators | $533 | 499% |
| Group Marketing Services | $533 | 499% |
| Guardian | $533 | 499% |
| Health America | $533 | 499% |
| Healthcare Management Admin | $533 | 499% |
| Healthez | $533 | 499% |
| Humana | $533 | 499% |
| Insight | $533 | 499% |
| Intercare | $533 | 499% |
| Jfp Benefit Management | $533 | 499% |
| Jp Farley Corporation | $533 | 499% |
| Key Benefit Administrator | $533 | 499% |
| Liberty Union Life Assurance Co | $533 | 499% |
| Lucent Health | $533 | 499% |
| Luminare Health | $533 | 499% |
| Magnacare | $533 | 499% |
| Medben | $533 | 499% |
| Medcost | $533 | 499% |
| Medical Mutual | $533 | 499% |
| Mutual Health Services | $533 | 499% |
| Mutual Of Omaha | $533 | 499% |
| Ncas | $533 | 499% |
| Nippon Life Ins | $533 | 499% |
| Nova | $533 | 499% |
| Painters Union Insurance Fund | $533 | 499% |
| Physicians Mutual | $533 | 499% |
| Plumbers Local 98 Insurance Fund | $533 | 499% |
| Prairie States | $533 | 499% |
| Preferred One | $533 | 499% |
| Primary Physician Care | $533 | 499% |
| Professional Benefit Administrators | $533 | 499% |
| Siho Insurance Services | $533 | 499% |
| The Loomis Company | $533 | 499% |
| Unicare | $533 | 499% |
| Us Health And Life | $533 | 499% |
| Valenz | $533 | 499% |
| Western & Southern Financial Group | $533 | 499% |
| Wps | $533 | 499% |
| 1199 National Benefit Fund | $538 | 504% |
| Allied National Global Care | $538 | 504% |
| Asrm - Reliance Standard Life Insurance | $538 | 504% |
| Christian Care Ministry | $538 | 504% |
| Dean Health | $538 | 504% |
| Fallon Health | $538 | 504% |
| Family Life Insurance Company | $538 | 504% |
| Ghc Scw | $538 | 504% |
| Group Pension Administrators | $538 | 504% |
| International Benefit Administrators | $538 | 504% |
| Lifetime Benefit Solutions | $538 | 504% |
| Manhattan Life | $538 | 504% |
| Medi Share | $538 | 504% |
| Multiplan | $538 | 504% |
| Mvp | $538 | 504% |
| Pai | $538 | 504% |
| Pan-American Life | $538 | 504% |
| Paramount Hmo | $538 | 504% |
| Phcs | $538 | 504% |
| Trinity Health Share | $538 | 504% |
| First Health | $549 | 514% |
| Coventry | $672 | 629% |
| Prime Health Services | $672 | 629% |
| Three Rivers Provider Network | $756 | 708% |
| Carelon Behavioral Health | $840 | 786% |
| Cmh Detroit Wayne Integrated Health Network | $840 | 786% |
| Cmh Lenawee County | $840 | 786% |
| Cmh Livingston County | $840 | 786% |
| Cmh Misc | $840 | 786% |
| Cmh Monroe County | $840 | 786% |
| Cmh Washtenaw County | $840 | 786% |
| Magellan Behavioral Health | $840 | 786% |