CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Louis Childrens Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $1,379
  • Cash Discount Price: $1,118
  • vs. Medicare Baseline: 12.91x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Louis Childrens Hospital is $1,379. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,118. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.91x the Medicare baseline. Located in One Childrens Place, Saint Louis, MO.
Cash / Self-Pay
$1,118

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,379

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: $1,118 (1047%)
Insurance Median: $1,379 (1291%)
Cash: $1,118 (1047% of Medicare)
Ins. Median: $1,379 (1291% 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 1291% of the Medicare baseline (a markup of 1191%). 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 $103 - $1,473 96%
Blue Cross Blue Shield $103 - $1,584 96%
Essence Healthcare [221] $103 96%
Humana $103 - $1,389 96%
UnitedHealthcare $103 - $1,385 96%
Cox Health [757] $108 101%
Medica [662] $108 101%
Healthlink [225] $904 - $1,407 846%
Cigna $921 - $1,012 862%
Consociate [478] $1,010 946%
Sarah Bush Lincoln [636] $1,010 946%
Apwu Health Plan [216] $1,012 947%
Nalc Health Benefit Plan [242] $1,012 947%
Priority Health [648] $1,012 947%
Allied Benefits [498] $1,081 - $1,473 1012%
Hope Trust [806] $1,081 1012%
Cox Health Systems Insurance Company [220] $1,212 - $1,379 1135%
Med-Pay [480] $1,212 - $1,398 1135%
Unicare [568] $1,212 - $1,407 1135%
Health Alliance [224] $1,305 1222%
Healthscope Benefits [258] $1,329 - $1,491 1244%
First Health Commercial [734] $1,385 1297%
Beechstreet [551] $1,398 1309%
Detego Health [868] $1,398 1309%
Health Systems Inc [620] $1,398 1309%
Healthcare Sol Mercy [609] $1,398 1309%
Multiplan Commercial [737] $1,398 1309%
Multiplan [240] $1,398 1309%
Phcs [244] $1,398 - $1,491 1309%
Preferred Health Professionals [561] $1,407 1317%
Coresource [497] $1,473 1379%
Fmh Benefit Service Inc [222] $1,473 1379%
Mail Handlers [495] $1,473 1379%
Medica [661] $1,491 1396%
Hfn [563] $1,584 1483%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Childrens Place, Saint Louis, MO 63110
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens