Ultrasound, thyroid and neck
Facility: Kansas Medical Center Llc
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $96
- Cash Discount Price: $380
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| Indian Health | $87 | 81% |
| Tricare | $87 | 81% |
| Medadv_Wellcare | $96 | 90% |
| Ambetter / Centene | $96 | 90% |
| Blue Cross Blue Shield | $96 - $459 | 90% |
| Humana | $96 | 90% |
| Aetna | $171 | 160% |
| United | $191 | 179% |
| Three_Rivers | $193 | 181% |
| Wppa | $253 | 237% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck), Kansas Medical Center Llc in Andover, KS, lists a cash median price of $380.00, which is lower than the facility's gross charge of $633.00. While the facility's negotiated rates with commercial payers average $96.00, these amounts are significantly higher than the cash price, meaning patients with high-deductible plans or those without insurance may save money by paying cash directly. It is important to note that while the facility's cash rate is competitive, the negotiated rates for in-network insurance plans can sometimes exceed the cash price due to administrative costs and contract structures; therefore, patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the best possible rate.
When evaluating this service against broader benchmarks, the Medicare allowed amount for this procedure is $106.81, and the facility's negotiated rate of $96.00 is slightly below the Medicare benchmark, suggesting a fair pricing structure relative to federal standards. However, commercial payers like Blue Cross Blue Shield show a wide range of negotiated rates ($96 to $459), indicating that specific plan contracts vary significantly. To avoid unexpected costs, consumers should request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so they should never feel pressured to pay a surprise difference without first disputing the bill with their insurer.