CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Reading Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $36
Cash Discount Price: $496
vs. Medicare Baseline: 0.34x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Reading Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.34x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.

Cash / Self-Pay

$496

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $496 (464%)

Insurance Median: $36 (34%)

Cash: $496 (464% of Medicare)

Ins. Median: $36 (34% 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	$22 - $26	21%
Blue Cross Blue Shield	$25 - $630	23%
UnitedHealthcare	$25 - $524	23%
Aetna	$26 - $922	24%
Amerihealth Caritas	$26 - $65	24%
Health America	$26	24%
Highmark	$26 - $32	24%
Upmc	$26 - $722	24%
Devoted Health	$27	25%
Gateway	$27 - $65	25%
Geisinger	$27 - $846	25%
Health Partners	$27 - $65	25%
Pa Health & Wellness	$27 - $64	25%
Lehigh Valley Health Network	$36 - $601	34%
Keystone First	$61	57%
Wernersville State Hospital	$66	62%
Cigna	$75 - $764	70%
First Health	$388 - $1,029	363%
Pma	$534	500%
Berkshire	$1,002	938%
Blue Ridge	$1,269	1188%

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 $496.
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 Reading 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.