CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UPMC Wellsboro

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $655
Cash Discount Price: $714
vs. Medicare Baseline: 6.13x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UPMC Wellsboro is $655. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $714. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.13x the Medicare baseline. Located in 32-36 Central Avenue, Wellsboro, PA.

Cash / Self-Pay

$714

Average discount available for prompt cash payment at this facility.

Insurance Median

$655

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: $714 (668%)

Insurance Median: $655 (613%)

Cash: $714 (668% of Medicare)

Ins. Median: $655 (613% 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 613% of the Medicare baseline (a markup of 513%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$65 - $915	61%
Amerihealth Caritas	$84	79%
Geisinger	$84 - $722	79%
Upmc Health Plan	$84 - $470	79%
Highmark Wholecare (Prev Gateway)	$85 - $215	80%
Health Partners Plans (Jefferson Health Plan)	$115	108%
Pa Health & Wellness	$130 - $233	122%
Aetna	$176 - $929	165%
Blue Cross Blue Shield	$195 - $545	183%
Upmc Work Partners	$195	183%
Cigna	$205 - $226	192%
Wirerope Works	$543 - $599	508%
Multiplan	$762 - $1,023	713%
America'S Choice	$879 - $969	823%
Intergroup	$879 - $969	823%

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 $714.
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 Wellsboro 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.