CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $211
Cash Discount Price: $425
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Independence Health System Butler Memorial Hospita is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $425. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.98x the Medicare baseline. Located in One Hospital Way, Butler, PA.

Cash / Self-Pay

$425

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $425 (398%)

Insurance Median: $211 (198%)

Cash: $425 (398% of Medicare)

Ins. Median: $211 (198% 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
Highmark	$53 - $216	50%
Highmark - Ind.& Managed Care	$53 - $240	50%
Highmark Aca - Direct Blue	$53 - $174	50%
Highmark Community Blue	$53 - $212	50%
Upmc	$55 - $980	51%
Medicaid / KanCare	$76	71%
UnitedHealthcare	$76 - $262	71%
Gateway	$79 - $980	74%
Geisinger	$83 - $933	78%
Amerihealth	$84 - $107	79%
Ellwood Group	$84 - $401	79%
Jefferson Health Plan	$84	79%
Aetna	$88 - $746	82%
Martin'S Point - Usfhp	$98 - $327	92%
Life Butler County	$102	95%
Medicare (plans)	$102	95%
Peak Health	$102 - $653	95%
Provider Partners	$102	95%
Tricare	$102	95%
Humana	$106	99%
Devoted Health Plan	$108 - $373	101%
The Health Plan	$108 - $240	101%
Pa Health & Wellness	$109	102%
American Health Plan	$113	106%
Pnoa	$113 - $746	106%
Workers Comp	$113	106%
Ccbh - Behavioral Health	$140 - $466	131%
Cigna	$140 - $466	131%
Private Healthcare Systems	$197 - $793	184%
Devon	$211 - $700	198%
Intergroup	$225 - $746	211%
Multiplan	$253 - $840	237%

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 $425.
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 Independence Health System Butler Memorial Hospita 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.