Ultrasound, thyroid and neck
Facility: Providence Medical Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $128
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.20x 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 |
|---|---|---|
| Aetna | $53 - $159 | 50% |
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $91 - $215 | 85% |
| Celtic | $93 - $158 | 87% |
| Healthy Blue | $93 - $103 | 87% |
| Cigna | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Tricare | $98 | 92% |
| Medicare (plans) | $98 | 92% |
| Kansas Superior Select | $103 | 96% |
| Corizon | $128 | 120% |
| Comp Alliance - Fka Compresults Worker Compensation | $131 | 123% |
| Employer Direct Healthcare | $138 | 129% |
| Well Path Prison | $138 | 129% |
| Oha Networks | $141 | 132% |
| Worker Compensation | $146 | 137% |
| Centurion | $148 | 139% |
| Naphcare | $153 | 143% |
| Blue Cross Blue Shield | $158 - $255 | 148% |
| First Health | $750 | 702% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Providence Medical Center in Kansas City, KS, the facility's cash median rate is $98.00, which is significantly lower than the state average of $128.00. While many commercial payers have negotiated rates ranging from $53 to $255, the cash price often represents the most affordable option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and markup inherent in insurance billing cycles. To secure this lower rate, patients should explicitly request a "self-pay" classification and inquire about prompt-pay discounts before scheduling, as waiting until after receiving a bill may result in the facility submitting a claim to insurance instead, which could void any cash agreement.
The facility's Medicare benchmark rate of $106.81 serves as a reliable baseline for evaluating pricing fairness, noting that commercial negotiated rates frequently exceed fair pricing thresholds. Although the facility is a voluntary non-profit church-owned acute care hospital, the wide variance in payer-specific rates—from Medicaid/KanCare at $60 to First Health at $750—highlights the importance of verifying your specific plan's allowed amount prior to service. Consumers should avoid accepting summary bills and instead demand a full itemized CPT-coded statement to identify any unbundled charges or services not rendered, ensuring that the final cost aligns with the transparent data provided and avoiding unexpected balance billing where applicable under federal protections.