CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Riverside Community Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $350
Cash Discount Price: $1,005
vs. Medicare Baseline: 3.28x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Riverside Community Hospital is $350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,005. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.28x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$1,005

Average discount available for prompt cash payment at this facility.

Insurance Median

$350

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: $1,005 (941%)

Insurance Median: $350 (328%)

Cash: $1,005 (941% of Medicare)

Ins. Median: $350 (328% 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 328% of the Medicare baseline (a markup of 228%). 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
La Care Health	$66	62%
Molina	$66	62%
Brand New Day	$73	68%
Inland Empire Health Plan	$96	90%
Blue Cross Blue Shield	$132 - $594	124%
Medcare Partners	$151	141%
Aetna	$181	169%
Blue Shield	$218 - $350	204%
United	$245 - $264	229%
Redlands Community	$302	283%
Cigna	$424	397%
First Health	$442 - $905	414%
American Health System	$452	423%
Healthsmart	$804	753%
Multiplan	$804 - $854	753%
Next	$804	753%

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 $1,005.
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 Riverside Community 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.