CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: M Health Fairview St John's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $113
Cash Discount Price: $245
vs. Medicare Baseline: 1.06x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at M Health Fairview St John's Hospital is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.06x the Medicare baseline. Located in 1575 Beam Avenue, Maplewood, MN.

Cash / Self-Pay

$245

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $245 (229%)

Insurance Median: $113 (106%)

Cash: $245 (229% of Medicare)

Ins. Median: $113 (106% 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.

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
Health Partners	$18 - $319	17%
Primewest	$18 - $105	17%
South Country Health Alliance	$18 - $105	17%
Medica	$19 - $403	18%
Ucare	$19 - $293	18%
Blue Cross Blue Shield	$21 - $376	20%
Itasca Medical Care	$21 - $105	20%
Sanford Health Plan	$25 - $382	23%
Security Health Plan	$25 - $486	23%
UnitedHealthcare	$25 - $270	23%
Wellcare	$25 - $105	23%
Hennepin Health	$28 - $119	26%
America'S Ppo	$74 - $467	69%
First Health	$80 - $531	75%
Multiplan	$83 - $551	78%
Private Healthcare Systems	$83 - $551	78%
Wisconsin Physician Services	$88 - $583	82%

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 $245.
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 M Health Fairview St John's 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.