CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $285
  • Cash Discount Price: $425
  • vs. Medicare Baseline: 2.67x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Essentia Health St Joseph's Medical Center is $285. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $425. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.67x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$425

Average discount available for prompt cash payment at this facility.

Insurance Median
$285

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: $425 (398%)
Insurance Median: $285 (267%)
Cash: $425 (398% of Medicare)
Ins. Median: $285 (267% 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 267% of the Medicare baseline (a markup of 167%). 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
Itasca Med Care $106 99%
Primewest $106 99%
Advocare/Security Health $114 107%
Blue Cross Blue Shield $114 - $442 107%
Freedom Blue Ppo $114 107%
Healthpartners Care Msho / Mcr Adv $114 107%
Imcare Msho Pcc Prime $114 107%
Imcare Msho Ref Req $114 107%
Medica Advantage Solutions $114 107%
Medica Msho/Dual Solutions $114 107%
Medica Prime Solution Group $114 107%
Medicare (plans) $114 107%
Nd Va Administration $114 107%
Platinum Blue/Vantage Blue $114 107%
Primewest Msho $114 107%
Secure Blue Msho $114 107%
Ubh Cost Plan $114 107%
Ubh Msho $114 107%
Ucare Msho $114 107%
UnitedHealthcare $114 - $481 107%
Medica Access $200 187%
Sanford Health Plan $271 - $285 254%
Healthpartners Care Pmap $272 255%
Blue Plus Pmap Pcc Prime $284 - $405 266%
Medica $402 - $447 376%
Medica Uplan $402 376%
Ucare $416 389%
Wea $455 - $487 426%
Medica Choice $460 431%
Cigna $465 435%
Healthpartners $465 435%
Healthpartners Pcc Prime $465 435%
America'S Ppo $490 459%
Wps $525 - $531 492%
Aetna $537 503%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals