CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Physicians Care Surgical Hospital

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $5,228
  • Cash Discount Price: $4,183
  • vs. Medicare Baseline: 48.95x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Physicians Care Surgical Hospital is $5,228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,183. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 48.95x the Medicare baseline. Located in 454 Enterprise Drive, Royersford, PA.
Cash / Self-Pay
$4,183

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,228

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: $4,183 (3916%)
Insurance Median: $5,228 (4895%)
Cash: $4,183 (3916% of Medicare)
Ins. Median: $5,228 (4895% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 4895% of the Medicare baseline (a markup of 4795%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Connecticare $124 116%
Blue Cross Blue Shield $194 - $5,647 182%
Highmark $194 182%
Aetna $393 - $5,856 368%
Ag Administrators $393 368%
Ag Administrators Inc $393 368%
Allied Benefit Systems $393 368%
Allied Benefits Systems $393 368%
Continental Benefits $393 368%
Coventry $393 368%
Geha $393 368%
Healthez $393 368%
Lucent Health $393 368%
Marpai Health $393 368%
Meritain Health $393 368%
Premier Care Network $393 368%
Trustmark $393 368%
Aarp $5,228 4895%
Cigna $5,228 4895%
Devon Health Services $5,228 4895%
Gpm Health And Life Insurance Mc Supplement $5,228 4895%
Humana $5,228 4895%
Ibc Security 65 $5,228 4895%
Keystone 65 Hmo $5,228 4895%
Medicare (plans) $5,228 4895%
Pcsh Aarp $5,228 4895%
Personal Choice 65 $5,228 4895%
Shenandoah Life $5,228 4895%
Tricare $5,228 4895%
Unified Health Services $5,228 4895%
UnitedHealthcare $5,228 - $11,093 4895%
Vibra Health Plan $5,228 4895%
Amerihealth Administrators $5,647 5287%
Amerihealth New Jersey Hmo $5,647 5287%
Carefirst Administrators $5,647 5287%
Empire Plan $5,647 5287%
Horizon Of New Jersey $5,647 5287%
Ibc $5,647 5287%
Ibc - Local $5,647 5287%
Ibc 2021 $5,647 5287%
Ibc Local $5,647 5287%
Independence Administrators $5,647 5287%
Independence Bc $5,647 5287%
Independence Federal $5,647 5287%
Keystone Direct Pos $5,647 5287%
Keystone Healthplan East $5,647 5287%
Keystone Hmo $5,647 5287%
Pcsh Ibc $5,647 5287%
Personal Choice $5,647 5287%
Regence Blue Shield $5,647 5287%
Allsavers $11,093 10386%
Golden Rule Op $11,093 10386%
Oxford Health Plan $11,093 10386%
Oxford Life Insurance Company $11,093 10386%
Surest $11,093 10386%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 454 Enterprise Drive, Royersford, PA 19468
  • CMS Rating: No CMS Rating
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals