CMS Price Transparency Data

Ultrasound, thyroid and neck

Facility: Mercy Hospital Pittsburg, Inc

Billing Code: 76536 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 76536
  • Insurance Median: $105
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Ultrasound, thyroid and neck at Mercy Hospital Pittsburg, Inc is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.98x the Medicare baseline. Located in 1 Mt Carmel Way, Pittsburg, KS.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$105

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: $573 (536%)
Insurance Median: $105 (98%)
Cash: $573 (536% of Medicare)
Ins. Median: $105 (98% 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.

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
Medicaid / KanCare $60 - $104 56%
Blue Cross Blue Shield $60 - $579 56%
Humana $70 - $102 66%
Aetna $70 - $749 66%
UnitedHealthcare $91 - $594 85%
Halo Hcr Inc Hospice Contracted [320432] $102 95%
Kindful Hospice [20434] $102 95%
Pace Of The Ozarks Contracted [320518] $102 95%
Tricare $102 95%
Mercy Hospice Okc [20252] $102 95%
Medicare (plans) $102 - $106 95%
Elara Caring Aspire Hospice [20433] $102 95%
Halo Hcr Inc Hospice [20432] $102 95%
American Health Advantage Of Ks Mcr Contracted [320508] $102 95%
Dept Of Veteran Affairs Contracted [320106] $102 95%
Kindful Hospice Contracted [320434] $102 95%
Cross Timbers Hospice [20098] $102 95%
Home State Health Plan Contracted [320187] $104 97%
Ambetter / Centene $104 97%
Providrs Care Network Contracted [320484] $197 184%
Health Choice Contracted [320166] $239 224%
Medica Contracted [320239] $321 301%
Cigna $455 - $467 426%
United Medical Resources Contracted [320454] $594 556%
Aither Health Contracted [320449] $705 660%
Yuzu Health Contracted [320521] $705 660%
Edison Health Solutions Contracted [320502] $705 660%
Mercy Benefit Admin Contracted [320251] $705 660%
Auxiant Contracted [320462] $705 660%
Imagine 360 Contracted [320494] $705 660%
Ebms Contracted [320493] $705 660%
Reflect Health Contracted [320492] $705 660%
American Healthcare Alliance Contracted [320020] $705 660%
Healthlink Contracted [320179] $705 660%
Workers Comp [20426] $705 660%
First Health Contracted [320128] $749 701%

Consumer Guidance & Cost Commentary

For the CPT code 76536 (Ultrasound, thyroid and neck) at Mercy Hospital Pittsburg, Inc, the facility's cash median rate is $573.00, which is significantly lower than the negotiated rates paid by most commercial payers. While the gross charge is $881.00, insurance contracts often result in higher out-of-pocket costs for patients; for instance, Blue Cross Blue Shield's negotiated range spans from $60 to $579, and UnitedHealthcare's range extends up to $594. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price of $573.00 upfront may be more cost-effective than relying on insurance, which could otherwise lead to balance billing if the provider is out-of-network or if ancillary services are not covered under the plan.

Patients should proactively contact the hospital to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative claim processing fees. It is also critical to request a full itemized billing audit before settling any debt, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. When evaluating the facility's pricing, it is more accurate to compare rates against the Medicare benchmark of $106.81 rather than the inflated chargemaster list price, as commercial negotiated rates often exceed fair pricing thresholds. Additionally, since this facility is a voluntary non-profit church-owned hospital in Pittsburg, KS, patients should verify their specific plan details to ensure they are utilizing the lowest possible rate, as some in-network contracts may still result in

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Mt Carmel Way, Pittsburg, KS 66762
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals