CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Children's Hospital of Philadelphia

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $1,171
Cash Discount Price: $3,501
vs. Medicare Baseline: 10.96x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Children's Hospital of Philadelphia is $1,171. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,501. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.96x the Medicare baseline. Located in 3401 Civic Center Blvd, Philadelphia, PA.

Cash / Self-Pay

$3,501

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,171

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: $3,501 (3278%)

Insurance Median: $1,171 (1096%)

Cash: $3,501 (3278% of Medicare)

Ins. Median: $1,171 (1096% 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 1096% of the Medicare baseline (a markup of 996%). 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
Geisinger Medical Assistance	$69	65%
Highmark Wholecare	$76	71%
Horizon Nj Health	$148	139%
UnitedHealthcare	$430 - $581	403%
Medicaid / KanCare	$578	541%
Health Partners	$660	618%
Geisinger Health Plan Commercial	$869	814%
Aetna	$921 - $1,751	862%
Upmc Medical Assistance	$956	895%
Keystone First Chip	$1,085	1016%
Keystone Health Plan East	$1,107	1036%
Blue Cross Blue Shield	$1,236 - $1,403	1157%
Jefferson Health Plans	$1,656	1550%
Cigna	$1,751	1639%
Highmark	$1,751	1639%
Qualcare	$1,926	1803%
First Health Network	$2,276	2131%
Devon Health, Intergroup, Multiplan, Valley Preferred/Populytics	$2,801	2622%
Private Health Care Systems	$2,801	2622%
Choice Care Network	$3,151	2950%

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 $3,501.
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 Children's Hospital of Philadelphia 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.