CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Pender Memorial Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $110
Cash Discount Price: $151
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Pender Memorial Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.03x the Medicare baseline. Located in 507 E Fremont St, Burgaw, NC.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $151 (141%)

Insurance Median: $110 (103%)

Cash: $151 (141% of Medicare)

Ins. Median: $110 (103% 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.

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
Humana	$86 - $288	81%
Blue Cross Blue Shield	$90 - $124	84%
Pace Of The Southern Piedmont	$90	84%
New Hanover Health	$92	86%
Aetna	$93 - $285	87%
Cigna	$93 - $148	87%
Carolina Complete	$94	88%
Nc Department Of Public Safety	$94 - $181	88%
Amerihealth	$96	90%
Wellcare	$96	90%
Ambetter / Centene	$127	119%
Liberty Health	$128	120%
Caresource North Carolina	$134	125%
Plotkin Health	$201	188%
UnitedHealthcare	$245	229%
Medcost	$252 - $281	236%
Employers Choice Network	$325	304%
Three Rivers Provider Network	$325	304%

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 $151.
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 Pender Memorial 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.