CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Valley Children's Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $698
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 6.53x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Valley Children's Hospital is $698. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.53x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$698

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%)
Insurance Median: $698 (653%)
Ins. Median: $698 (653% 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 653% of the Medicare baseline (a markup of 553%). 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
Allcare Ipa $86 81%
Kaiser $87 - $860 81%
Dignity Ipa_Formerly Img $120 112%
La Salle Ipa $120 112%
Sante Ipa $120 112%
Central Valley Medical Providers Ipa $129 - $662 121%
Sequoia Health Ipa $129 121%
Univseral Healthcare Ipa $129 121%
United Physicians Network Ipa $133 125%
Community Care Ipa $135 126%
Adventist $151 141%
Blue Cross Blue Shield $155 - $706 145%
Cencal Health $169 158%
Kern Family Health Care $171 160%
Central California Alliance For Health $174 163%
Health Net $466 - $866 436%
UnitedHealthcare $597 559%
Dignity Health Central Coast $656 614%
Community Health $728 682%
Stanislaus Partners In Health $728 682%
Physicians Choice Medical Group $741 694%
Health Plan Of San Joaquin $794 743%
Fowler Packing $820 768%
Dignity (Formerly Managed Care Systems) $833 780%
Kern Legacy $860 805%
Blue Shield $884 - $1,004 828%
Aetna $886 830%
First Health Formerly Coventry $979 917%
Bakersfield Family Medical Group $992 929%
Network By Design $1,025 960%
Community Care Health Plan $1,058 991%
Health Smart $1,058 991%
Key Medical Ipa $1,058 991%
Sutter Health $1,125 1053%
Multiplan $1,266 1185%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens