Ultrasound, thyroid and neck
Facility: Saint Luke'S South Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $514
- Cash Discount Price: $1,096
- vs. Medicare Baseline: 4.81x 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 481% of the Medicare baseline (a markup of 381%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $136 | 56% |
| Aetna | $87 - $1,735 | 81% |
| Humana | $87 - $143 | 81% |
| UnitedHealthcare | $90 - $514 | 84% |
| Cigna | $118 - $1,386 | 110% |
| Blue Cross Blue Shield | $120 - $1,371 | 112% |
| Transplants-Case Rates [5750] | $121 - $1,826 | 113% |
| Commercial-Contracted [8000] | $246 - $1,477 | 230% |
| First Health [5512] | $1,082 | 1013% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Saint Luke's South Hospital in Overland Park, KS, the cash median price is $1,096.00, while the facility's median negotiated rate across payers is $514.00. This suggests that for patients with high-deductible plans, paying cash upfront might be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price due to administrative overheads. The facility's cash rate is significantly higher than the Medicare benchmark of $106.81, which serves as the objective baseline for true cost; however, patients should verify if their specific insurance plan allows for cash-pay discounts, as some commercial contracts may result in higher out-of-pocket costs than self-pay options.
When reviewing the billing statement, it is crucial to request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. The data indicates a wide variance in negotiated rates among payers, ranging from $60 for Medicaid/KanCare to $1,826 for Transplants-Case Rates, highlighting that in-network status does not guarantee the lowest possible price. To minimize debt, patients should contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% if paid in full within 30 days, effectively bypassing the costly claims processing cycle that inflates insurance payments.