CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Hospital Pavia Hato Rey, Inc

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 76536
Insurance Median: $35
Cash Discount Price: $225
vs. Medicare Baseline: 0.33x Medicare

The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Hospital Pavia Hato Rey, Inc is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $225. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.33x the Medicare baseline. Located in Ave Ponce De Leon 435, Hato Rey, PR.

Cash / Self-Pay

$225

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $225 (211%)

Insurance Median: $35 (33%)

Cash: $225 (211% of Medicare)

Ins. Median: $35 (33% 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
Auxilio Salud Plus	$15	14%
Plan Socios Auxilio	$15	14%
Acaa	$21	20%
Tricare	$24	22%
Humana	$30 - $47	28%
Mapfre	$30	28%
Triple S	$30 - $91	28%
Corvel Network	$33	31%
Bl	$34	32%
Cigna	$35	33%
First Medical	$35 - $48	33%
Mc	$35	33%
Mcs	$35	33%
Prossam	$37	35%
Plan De Salud Menonita	$38 - $45	36%
Mso	$45 - $89	42%
Privado	$50	47%
Bella Vista	$60	56%
Fondo Del Seguro Estado	$60	56%
Ch	$70	66%
Aarp	$75	70%
Va	$89	83%

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 $225.
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 Hospital Pavia Hato Rey, Inc 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.