CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: UPMC Kane

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $190
Cash Discount Price: $185
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at UPMC Kane is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.78x the Medicare baseline. Located in 4372 Route 6, Kane, PA.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $185 (173%)

Insurance Median: $190 (178%)

Cash: $185 (173% of Medicare)

Ins. Median: $190 (178% 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
UPMC Health Plan	$36 - $229	34%
Blue Cross Blue Shield	$38 - $425	36%
Aetna	$40 - $198	37%
Highmark Wholecare (Prev Gateway)	$40 - $196	37%
UnitedHealthcare	$40 - $252	37%
Amerihealth Caritas	$42 - $205	39%
Horizon Health Plan	$73 - $360	68%
Cigna	$73 - $11,571	68%
Multiplan	$78 - $386	73%
Intergroup	$83 - $411	78%
Health Coalition Partners	$83 - $411	78%
Focus Healthcare	$99 - $488	93%
Geisinger	$106	99%
PA Health & Wellness	$130	122%
UPMC Work Partners	$195	183%

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 $185.
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 Kane 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.