CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: City of Hope National Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $616
Cash Discount Price: $880
vs. Medicare Baseline: 5.77x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at City of Hope National Medical Center is $616. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $880. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.77x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$880

Average discount available for prompt cash payment at this facility.

Insurance Median

$616

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: $880 (824%)

Insurance Median: $616 (577%)

Cash: $880 (824% of Medicare)

Ins. Median: $616 (577% 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 577% of the Medicare baseline (a markup of 477%). 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
Health Net	$46 - $853	43%
Cal Optima	$64 - $95	60%
Heritage Provider Network	$75 - $616	70%
Inland Empire	$99 - $704	93%
Prime Healthcare Keenan	$167 - $844	156%
Blue Cross Blue Shield	$407 - $616	381%
UnitedHealthcare	$493 - $539	462%
Blue Shield	$521 - $1,048	488%
Blue Shield Covca	$535	501%
Cigna	$573	536%
Blue Shield Promise	$616	577%
Cencal	$704	659%
La Care Health	$704	659%
Kaiser	$792	742%
Aetna	$880	824%
Gold Coast	$880	824%
Molina	$880 - $1,143	824%
Facey	$967	905%
Healthcare Partners	$1,020	955%
St. Joseph Heritage	$1,055	988%
Primecare Medical Network	$1,143	1070%
First Health	$1,354	1268%
Phcs Multiplan	$1,583	1482%

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 $880.
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 City of Hope National Medical Center 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.