CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Nemours Children's Hospital, Delaware

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $499
  • Cash Discount Price: $883
  • vs. Medicare Baseline: 4.67x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Nemours Children's Hospital, Delaware is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $883. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.67x the Medicare baseline. Located in 1600 Rockland Rd Po Box 269, Wilmington, DE.
Cash / Self-Pay
$883

Average discount available for prompt cash payment at this facility.

Insurance Median
$499

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: $883 (827%)
Insurance Median: $499 (467%)
Cash: $883 (827% of Medicare)
Ins. Median: $499 (467% 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 467% of the Medicare baseline (a markup of 367%). 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
Us Family Health Plan $43 40%
Tricare $111 104%
Keystone First Hlth Plan $176 - $391 165%
Celtic Transplant $185 - $883 173%
Amerihealth Caritas Delaware $271 - $503 254%
Blue Cross Blue Shield $273 - $780 256%
Celtic Transplant For De First Health $309 289%
Delaware First Health $318 298%
UnitedHealthcare $324 - $551 303%
Wellpoint Maryland $327 306%
Kidz Partners $334 313%
Health Partners $343 321%
Upmc $350 328%
Fidelis $353 330%
Aetna $375 - $512 351%
Priority Partners John Hopkins $433 405%
Six Degrees Health Transplant $442 414%
Cigna $486 - $556 455%
Great West-One Health Plan $486 - $556 455%
Ambetter / Centene $503 471%
Geisinger Health Plan $530 496%
Integra Administrative Group $530 496%
National Transplant Network (Ntn) $574 537%
Six Degrees Health $574 537%
Star Healthcare Network $574 537%
Life Trac Solid Organ And Bmt Transplant $618 579%
First Health Network $839 786%
Insurance Administrators Of America $839 786%
Interlink Transplant Network $839 786%
Multiplan $839 786%
Preferred Healthcare $839 786%
Private Healthcare Systems $839 786%
Three Rivers Provider Network $839 786%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1600 Rockland Rd Po Box 269, Wilmington, DE 19899
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens