Ultrasound, thyroid and neck
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $582
- Cash Discount Price: $426
- vs. Medicare Baseline: 5.45x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 545% of the Medicare baseline (a markup of 445%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $582 | 545% |
| Blue Cross Blue Shield | $582 | 545% |
| Healthcare Highways [2210] | $582 | 545% |
| Oncology Patient Assistance Programs [2295] | $582 | 545% |
| Lucent Health [6000] | $582 | 545% |
| Web Tpa [2115] | $582 | 545% |
| Black Lung [6055] | $582 | 545% |
| Hooray Health [8000] | $582 | 545% |
| Department Of Corrections [1340] | $710 | 665% |
| National Association Of Letter Carriers [1695] | $821 | 769% |
| American Postal Workers Union [1070] | $821 | 769% |
| Healthpartners [1500] | $821 | 769% |
| Cigna | $821 | 769% |
| Humana | $838 | 785% |
| American Healthcare [1055] | $1,103 | 1033% |
| Administrative Concepts [1005] | $1,103 | 1033% |
| First Health [1375] | $1,103 | 1033% |
| Multiplan [1680] | $1,103 | 1033% |
| Coventry Healthcare [1320] | $1,164 | 1090% |
| Ks Disability Determination [6090] | $1,420 | 1329% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at the University of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rate is $582, which aligns with the lowest payment amounts observed across 20 different payers. This rate is significantly higher than the cash median of $426, illustrating a common scenario where paying out-of-pocket upfront can result in substantial savings compared to insurance reimbursement. While the facility is a voluntary non-profit church-owned acute care hospital, patients should be aware that their specific insurance plan may negotiate a rate that exceeds the cash price; therefore, individuals with high-deductible plans might find it financially advantageous to pay the lower cash rate directly, provided they secure a prompt-pay discount before scheduling.
The facility's billing practices reflect standard industry dynamics where commercial negotiated rates often exceed the true cost of care as measured by Medicare benchmarks. In this case, the Medicare amount for this procedure is $106.81, meaning the negotiated rate of $582 represents a markup well above the federal baseline. To ensure you are not overpaying, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, since the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, you should verify that all ancillary services were billed correctly and dispute any unexpected charges with your insurer rather than paying immediately out of fear.