CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Adventist Health Delano

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $215
Cash Discount Price: $178
vs. Medicare Baseline: 2.01x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Adventist Health Delano is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.01x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$178

Average discount available for prompt cash payment at this facility.

Insurance Median

$215

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: $178 (167%)

Insurance Median: $215 (201%)

Cash: $178 (167% of Medicare)

Ins. Median: $215 (201% 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 201% of the Medicare baseline (a markup of 101%). 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
Blue Cross Blue Shield	$40 - $740	37%
Dignty Hlth Com/Mcr Op Only - All Other Plans	$55	51%
Dignty Hlth Mcal Op Only	$55	51%
Kaiser Medi-Cal Ip/Op Only	$86	81%
Medi-Cal	$86	81%
Universal Care Mcal	$86	81%
Healthnet Medi-Cal	$102	95%
Kern Health System Mcal	$111	104%
Bakersfield Fam Med Grp-All Plans	$134	125%
Healthnet Mcr Adv	$134	125%
Kern Mcr Adv Dual Dnsp-All Other Plans	$134	125%
Medicare (plans)	$134 - $215	125%
Tricare	$134	125%
UnitedHealthcare	$134 - $640	125%
Universal Care Mcr- All Other Plans	$134	125%
Blue Shield Epn - All Other Plans	$195	183%
Kaiser Comm Ip/Op Only- All Other Plans	$231	216%
Ah Employee Health Plan - All Plans	$242	227%
Centivo - All Plans	$303	284%
Coventry- All Plans	$533	499%
Blue Shield Non-Epn	$578	541%
Healthnet- All Other Plans	$598	560%
County Of Kern Network - All Plans	$622	582%
Gem Care- All Plans	$622	582%
Aetna	$656	614%
Foundation For Medical Care Of Kern County - All P	$667	624%
Cigna	$711	666%
Western Growers - All Plans	$720	674%

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 $178.
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 Adventist Health Delano 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.