Ultrasound, thyroid and neck
Facility: Wesley Medical Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $576
- Cash Discount Price: $3,327
- vs. Medicare Baseline: 5.39x 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 539% of the Medicare baseline (a markup of 439%). 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 |
|---|---|---|
| UnitedHealthcare | $60 | 56% |
| Medicaid / KanCare | $62 | 58% |
| Aetna | $62 - $1,188 | 58% |
| Amerigroup | $62 | 58% |
| First Health | $138 - $1,534 | 129% |
| Multiplan | $144 - $2,994 | 135% |
| United | $245 - $1,497 | 229% |
| Blue Cross Blue Shield | $433 | 405% |
| Health Partners Of Kansas | $576 - $1,664 | 539% |
| Wppa | $579 | 542% |
| Ambetter / Centene | $599 | 561% |
| Preferred Health Choices | $629 | 589% |
| Medical Associates Health Plan | $629 | 589% |
| Spirit Aerosystems | $1,065 | 997% |
| Triwest Healthcare Alliance | $2,163 | 2025% |
| Usa Managed Care | $2,828 | 2648% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Wesley Medical Center in Wichita, KS, the cash price is $3,327.00, which matches the facility's cash median. This rate is significantly higher than the state average, reflecting a 5.4x markup compared to Medicare's benchmark rate of $106.81 for this procedure. While commercial insurance plans like Aetna and Multiplan have negotiated rates ranging from $62 to nearly $3,000, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance negotiated rates can sometimes be higher than the out-of-pocket cash cost.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the administrative overhead of insurance claims. It is also important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. Finally, while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should verify their specific plan details and deductible status to ensure they are not unexpectedly responsible for the full negotiated amount before scheduling the procedure.