CMS Price Transparency Data
Ultrasound, thyroid and neck
Facility: Pennsylvania Hospital
Billing Code: 76536 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 76536
- Insurance Median: $191
- Cash Discount Price: $966
- vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Pennsylvania Hospital is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $966. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.79x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$966
Average discount available for prompt cash payment at this facility.
Insurance Median
$191
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: $966 (904%)
Insurance Median: $191 (179%)
Cash: $966 (904% of Medicare)
Ins. Median: $191 (179% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Horizon Nj Health | $32 - $306 | 30% |
| UnitedHealthcare | $39 - $1,740 | 37% |
| Pgm - Regie De L'Assurance Maladie Quebec | $44 - $400 | 41% |
| Preferred Health Care Eliance | $50 - $452 | 47% |
| Gateway Health Plan | $51 - $136 | 48% |
| Medicaid / KanCare | $51 - $1,740 | 48% |
| Health Partners | $58 - $1,740 | 54% |
| Keystone Mercy Health Plan | $65 | 61% |
| Pgm - Kuwait Defense | $67 - $783 | 63% |
| Devon | $73 - $783 | 68% |
| Qualcare | $73 - $661 | 68% |
| Coventry | $76 - $887 | 71% |
| Pa Medical Assistance | $76 | 71% |
| Pgm - Chop | $76 - $696 | 71% |
| Upmc | $76 - $1,740 | 71% |
| Wissahickon Hospice | $76 - $696 | 71% |
| Healthamerica/Coventry | $86 - $853 | 81% |
| Blue Cross Blue Shield | $90 - $1,740 | 84% |
| Keystone Hmo Proactive | $90 | 84% |
| Ibc Commercial Hpn | $93 | 87% |
| Olympus | $93 - $846 | 87% |
| First Health Global | $96 - $870 | 90% |
| Urn-Cancer Resource Services | $96 - $870 | 90% |
| Medicare (plans) | $109 - $112 | 102% |
| Philadelphia Va Medical Center | $109 | 102% |
| Tricare | $110 | 103% |
| Ibc | $112 | 105% |
| Cigna | $113 - $237 | 106% |
| Geisinger Health Plan | $113 - $347 | 106% |
| Humana | $113 - $1,392 | 106% |
| Health Net | $115 - $1,044 | 108% |
| Pa Health And Wellness | $115 - $180 | 108% |
| Penn Life (Living Independently For Elders) | $115 | 108% |
| Pgm - Royal Embassy Of Saudi Arabia | $115 - $1,044 | 108% |
| Aetna | $116 - $1,740 | 109% |
| Clover Health Plan | $118 | 110% |
| Keystone First | $121 | 113% |
| Pgm - Embassy Of Qatar | $124 - $1,131 | 116% |
| Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) | $124 - $1,131 | 116% |
| Us Family Health Plan | $126 | 118% |
| Pgm - Embassy Of The United Emirates/Ipc | $134 - $1,218 | 125% |
| Devon Health Services Inc | $153 - $1,392 | 143% |
| Health America/Ccn | $153 - $1,392 | 143% |
| Intergroup | $153 - $1,392 | 143% |
| Pgm - Kuwait Health Division | $153 - $1,392 | 143% |
| Pgm - Kuwait Oil | $153 - $1,392 | 143% |
| Preferred Care | $153 - $1,392 | 143% |
| Elap | $155 | 145% |
| Claims Watcher | $175 - $197 | 164% |
| Oscar Health Plan | $186 | 174% |
| Commercial Other | $191 - $1,740 | 179% |
| Community Behavioral Health | $191 - $1,740 | 179% |
| International Pfs | $191 - $1,740 | 179% |
| Quest Behavioral Health | $191 - $1,740 | 179% |
| United Behavioral Health | $191 - $1,740 | 179% |
| Workers Compensation | $191 - $1,740 | 179% |
| Centivo | $197 | 184% |
| Elap Services | $203 | 190% |
| Highmark | $230 | 215% |
| Penn Global Medicine | $290 | 272% |