CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: St Mary Medical Center

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $203
  • Cash Discount Price: $861
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at St Mary Medical Center is $203. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $861. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.90x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$861

Average discount available for prompt cash payment at this facility.

Insurance Median
$203

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: $861 (806%)
Insurance Median: $203 (190%)
Cash: $861 (806% of Medicare)
Ins. Median: $203 (190% 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.

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 $84 - $641 79%
Medicaid / KanCare $88 - $183 82%
Aetna $111 - $1,179 104%
Blue Cross Blue Shield $113 - $338 106%
Cigna $114 - $346 107%
Align Senior Care $115 108%
Medicare (plans) $116 - $203 109%
Health America Advantra $135 126%
Pace-Trinity Health $146 137%
Keystone First $183 171%
Keystone First Chip $183 171%
Ambetter / Centene $201 188%
Oscar $203 190%
Prime Healthcare $203 190%
Jefferson Health Plan Commercial $205 192%
Homestead Health Plans Woods Center $220 206%
Group Pension Administrators $254 238%
Reedman Toll $254 238%
Amerihealth $279 261%
Blue Shield - Ca $279 261%
Blue Shield - Id (Regence) $279 261%
Blue Shield - Ny Highmark Western $279 261%
Blue Shield - Wa (Regence) $279 261%
Blue Shield - Pa (Highmark) $305 286%
Upmc Health Plan $346 324%
Webtpa $346 324%
Geha $541 507%
Meritain $1,179 1104%
Multiplan $1,192 1116%
Prime Health Services $1,192 1116%
Galaxy Health Network $1,259 1179%
Three Rivers Provider Network $1,259 1179%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals