Ultrasound, thyroid and neck
Facility: Kansas City Orthopaedic Institute
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $254
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.38x 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 238% of the Medicare baseline (a markup of 138%). 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 | $98 | 92% |
| UnitedHealthcare | $98 | 92% |
| Cigna | $100 | 94% |
| Blue Cross Blue Shield | $254 | 238% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rates range from $98 to $254 depending on the insurance carrier. While the median negotiated rate of $254 is significantly higher than the Medicare benchmark of $106.81, indicating a markup of 2.4 times the federal rate, patients should consider that cash payments may offer a lower total cost. Although specific cash and median paid amounts are not listed for this service, the data suggests that for individuals with high-deductible plans, paying the facility directly could result in lower out-of-pocket expenses compared to the insurance negotiated rates, provided the patient qualifies for self-pay or prompt-pay discounts.
It is important to note that hospitals often issue summary bills that obscure individual charges, making it difficult to identify errors or unbundled services. To ensure you are not overcharged, request a full itemized CPT-coded bill before finalizing payment, as this allows you to verify that all services rendered are accurately listed and that no unnecessary components have been billed separately. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, you should still verify your deductible status and ask the billing department about any available prompt-pay discounts before scheduling your appointment to avoid unexpected financial burdens.