CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UPMC Williamsport

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $514
Cash Discount Price: $646
vs. Medicare Baseline: 4.81x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UPMC Williamsport is $514. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $646. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.81x the Medicare baseline. Located in 700 High Street, Williamsport, PA.

Cash / Self-Pay

$646

Average discount available for prompt cash payment at this facility.

Insurance Median

$514

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: $646 (605%)

Insurance Median: $514 (481%)

Cash: $646 (605% of Medicare)

Ins. Median: $514 (481% 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 481% of the Medicare baseline (a markup of 381%). 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
UnitedHealthcare	$65 - $737	61%
Geisinger	$84 - $722	79%
Upmc Health Plan	$84 - $470	79%
Amerihealth Caritas	$86 - $104	81%
Blue Cross Blue Shield	$102 - $505	95%
Aetna	$104 - $711	97%
Highmark Wholecare (Prev Gateway)	$107 - $109	100%
Pa Health & Wellness	$109 - $130	102%
Upmc Work Partners	$212	198%
Three Rivers Provider Network	$227 - $969	213%
Multiplan	$235 - $840	220%
Coventry/First Health	$540 - $725	506%
Wirerope Works	$599	561%
Cigna	$738	691%
America'S Choice	$862	807%
Intergroup	$862	807%

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 $646.
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 UPMC Williamsport 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.