CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Jfk University Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $304
Cash Discount Price: $112
vs. Medicare Baseline: 2.85x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Jfk University Medical Center is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.85x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$304

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: $112 (105%)

Insurance Median: $304 (285%)

Cash: $112 (105% of Medicare)

Ins. Median: $304 (285% 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 285% of the Medicare baseline (a markup of 185%). 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
Karna	$48 - $214	45%
Aetna	$106 - $1,026	99%
Amerigroup	$106 - $118	99%
Horizon	$106 - $1,135	99%
Vaccn	$106 - $118	99%
Wellcare	$106 - $118	99%
United Community/Americhoice	$112 - $124	105%
Blue Cross Blue Shield	$118	110%
Amerihealth	$146 - $161	137%
UnitedHealthcare	$210 - $661	197%
Clover	$220	206%
Seoul Medical Group	$263	246%
Oxford	$295 - $661	276%
Cigna	$331	310%
Activecare First McO	$855	800%
Intergroup	$855	800%
Bergen Risk	$916	858%
Qualcare	$944 - $989	884%
Prime Health	$977	915%
Multiplan - PHCS	$1,038	972%
Brighton Health Plan	$1,099	1029%

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 $112.
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 Jfk University 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.