Ultrasound, thyroid and neck
Facility: Mercy Specialty Hospital Southeast Kansas
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $340
- Cash Discount Price: $600
- vs. Medicare Baseline: 3.18x 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 318% of the Medicare baseline (a markup of 218%). 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 | $54 - $102 | 51% |
| Blue Cross Blue Shield | $60 - $372 | 56% |
| Aetna | $70 - $102 | 66% |
| Humana | $70 - $104 | 66% |
| Provider Partners Health Plans Contracted [320450] | $75 | 70% |
| First Health Contracted [320128] | $79 | 74% |
| UnitedHealthcare | $91 - $854 | 85% |
| Kindful Hospice Contracted [320434] | $102 | 95% |
| Mercy Hospice Okc [20252] | $102 | 95% |
| Pace Of The Ozarks Contracted [320518] | $102 | 95% |
| Tricare | $102 | 95% |
| Kindful Hospice [20434] | $102 | 95% |
| Elara Caring Aspire Hospice [20433] | $102 | 95% |
| Qual Choice Contracted [320325] | $102 | 95% |
| Cherokee Nation Health Serv Contracted [320066] | $102 | 95% |
| Cigna | $102 - $467 | 95% |
| Halo Hcr Inc Hospice [20432] | $102 | 95% |
| Mercy Mgd Behavioral Health Contracted [320259] | $102 | 95% |
| Medical Associates Health Contracted [320444] | $102 | 95% |
| Medicare (plans) | $102 | 95% |
| Halo Hcr Inc Hospice Contracted [320432] | $102 | 95% |
| Cross Timbers Hospice [20098] | $102 | 95% |
| Globalhealth Contracted [320145] | $102 | 95% |
| Dept Of Veteran Affairs Contracted [320106] | $104 | 97% |
| Centivo Contracted [320505] | $104 | 97% |
| United Medical Resources Contracted [320454] | $155 - $344 | 145% |
| Providrs Care Network Contracted [320484] | $197 | 184% |
| Medica Contracted [320239] | $336 | 315% |
| Health Systems Inc Contracted [320174] | $344 | 322% |
| Point C Contracted [320238] | $344 - $692 | 322% |
| Healthscope Contracted [320182] | $344 - $692 | 322% |
| Benefit Management Contracted [320052] | $344 | 322% |
| Insurance System Inc Contracted [320465] | $344 | 322% |
| Show-Me Health Administrators Contracted [320483] | $452 | 423% |
| Mercy Benefit Admin Contracted [320251] | $452 - $646 | 423% |
| Aither Health Contracted [320449] | $646 | 605% |
| American Healthcare Alliance Contracted [320020] | $646 | 605% |
| Imagine 360 Contracted [320494] | $646 | 605% |
| Ebms Contracted [320493] | $646 | 605% |
| Edison Health Solutions Contracted [320502] | $646 | 605% |
| Auxiant Contracted [320462] | $646 - $692 | 605% |
| Yuzu Health Contracted [320521] | $646 | 605% |
| Reflect Health Contracted [320492] | $646 | 605% |
| Federal Medical Center Contracted [320127] | $692 | 648% |
| Preferred Health Plan Contracted [320522] | $692 | 648% |
| Healthlink Contracted [320179] | $692 | 648% |
| Compcare Of The Ozarks Contracted [320437] | $729 | 683% |
| Workers Comp [20426] | $738 | 691% |
| Private Health Care Systems Contracted [320320] | $854 | 800% |
| Multiplan [20270] | $877 | 821% |
| Multiplan Contracted [320270] | $877 | 821% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck (CPT 76536), Mercy Specialty Hospital Southeast Kansas lists a gross charge of $923.00, with a cash median price of $600.00. This cash rate is significantly lower than the facility's negotiated rates, which range from $54 to $877 depending on the insurance carrier. For patients with high-deductible plans or those without insurance, paying the cash median of $600.00 upfront may be more cost-effective than relying on insurance, as many commercial payers negotiate rates that exceed the cash price. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can further reduce the final amount owed.
When evaluating the facility's pricing against national standards, it is important to compare rates to the Medicare benchmark rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $106.81, which serves as the objective baseline for determining fair pricing. While the facility's cash rate of $600.00 is higher than the Medicare rate, commercial negotiated rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of Medicare. To ensure transparency and avoid unexpected costs, patients should request an itemized bill to verify that no services were unbundled or double-billed, and they should check their specific plan's deductible status before assuming the negotiated rate will apply.