CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Indiana Regional Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $109
Cash Discount Price: $243
vs. Medicare Baseline: 1.02x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Indiana Regional Medical Center is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.02x the Medicare baseline. Located in 835 Hospital Road, Indiana, PA.

Cash / Self-Pay

$243

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $243 (228%)

Insurance Median: $109 (102%)

Cash: $243 (228% of Medicare)

Ins. Median: $109 (102% 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
UnitedHealthcare	$59 - $270	55%
Upmc Health Plan	$61 - $402	57%
Amerihealth Caritas	$67 - $113	63%
Geisinger Health Plan	$67 - $113	63%
Ambetter / Centene	$69 - $113	65%
Highmark Wholecare	$74 - $109	69%
Highmark	$84 - $300	79%
Humana	$100 - $107	94%
Tricare	$100 - $674	94%
Aetna	$101 - $334	95%
Cigna	$101 - $279	95%
Medicare (plans)	$101 - $109	95%
United Mine Workers Of America	$101 - $109	95%
Geisinger	$142 - $305	133%
Pa Health And Wellness Commercial	$142 - $305	133%
Department Of Human Services And Torrance State Hospital	$425	398%
Premier Comp Solutions, Llc	$607	568%
Miscellaneous Commercial	$674	631%
Pa Workers Compensation	$674	631%

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 $243.
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 Indiana Regional 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.