Ultrasound, thyroid and neck
Facility: Lmh
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $105
- Cash Discount Price: $230
- vs. Medicare Baseline: 0.98x 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.
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 |
|---|---|---|
| Humana | $39 - $105 | 37% |
| UnitedHealthcare | $39 - $612 | 37% |
| Cigna | $39 - $615 | 37% |
| Medicare (plans) | $39 - $105 | 37% |
| Haskell Indian Health Services | $46 - $105 | 43% |
| Blue Cross Blue Shield | $46 - $691 | 43% |
| Allwell | $47 - $107 | 44% |
| Ambetter / Centene | $47 - $163 | 44% |
| Aetna | $587 - $764 | 550% |
| Non Contracted | $737 | 690% |
| First Health | $857 | 802% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Lmh in Lawrence, KS, the facility's cash price of $230 is significantly lower than the gross charge of $921. While the facility is government-owned and holds a 4-star rating, commercial insurance rates vary widely; for instance, Aetna plans negotiated rates between $587 and $764, whereas non-contracted rates reached $857. This disparity highlights that in-network coverage does not guarantee the lowest possible price, as some insurers pay rates nearly four times the cash amount. Patients with high-deductible plans may find it financially advantageous to pay the $230 cash price directly, especially since the facility offers prompt-pay discounts that could further reduce the cost before insurance billing cycles begin.
To ensure you are not overpaying, it is essential to compare these rates against the Medicare benchmark of $106.81, which serves as the objective baseline for true healthcare costs. Although the data does not provide a specific county or state average for this procedure, the facility's cash rate is more than double the Medicare amount, reflecting standard administrative markups common in acute care hospitals. Before scheduling, verify your specific plan's negotiated rate with the hospital, as some carriers like Humana and Medicare plans have much lower allowed amounts ($39–$105) compared to others. Always request a formal itemized bill and ask about self-pay or prompt-pay discounts prior to check-in to avoid unexpected balance billing or administrative fees.