CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UPMC Hanover

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $209
Cash Discount Price: $394
vs. Medicare Baseline: 1.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UPMC Hanover is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $394. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.96x the Medicare baseline. Located in 300 Highland Ave, Hanover, PA.

Cash / Self-Pay

$394

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $394 (369%)

Insurance Median: $209 (196%)

Cash: $394 (369% of Medicare)

Ins. Median: $209 (196% 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	$67 - $484	63%
Amerihealth Caritas	$97	91%
Highmark Wholecare (Prev Gateway)	$97	91%
Upmc Health Plan	$99 - $460	93%
Blue Cross Blue Shield	$101 - $446	95%
Humana	$102	95%
Health Partners Plans (Jefferson Health Plan)	$104	97%
Aetna	$106 - $478	99%
Cigna	$107 - $589	100%
Geisinger	$107 - $475	100%
Pa Health & Wellness	$110 - $130	103%
Keystone Health Plan	$125 - $446	117%
Prime Net	$159 - $205	149%
Keystone Autism Services	$163	153%
Premier Comp Solutions	$209	196%
Upmc Work Partners	$209	196%
Carefirst	$558	522%
Multiplan	$558	522%
Wellspan Population Health	$572	536%

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 $394.
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 Hanover 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.