Ultrasound, thyroid and neck
Facility: Ellinwood District Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $441
- Cash Discount Price: $536
- vs. Medicare Baseline: 4.13x 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 413% of the Medicare baseline (a markup of 313%). 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 |
|---|---|---|
| Humana | $441 | 413% |
| Cigna | $441 | 413% |
| Blue Cross Blue Shield | $441 | 413% |
| Aetna | $441 | 413% |
| UnitedHealthcare | $441 | 413% |
Consumer Guidance & Cost Commentary
For the CPT code 76536, "Ultrasound, thyroid and neck," Ellinwood District Hospital in Ellinwood, KS, has a cash median price of $536.00 and a median negotiated rate of $441.00 across five major payers, including Humana, Cigna, and UnitedHealthcare. While the facility is a Critical Access Hospital owned by a Government Hospital District, the cash price is notably higher than the negotiated rates, which may be advantageous for patients with high-deductible plans who have not yet met their out-of-pocket maximum. In such cases, paying the cash price of $536.00 could result in lower total costs compared to the insurance negotiated rate of $441.00 if the patient's deductible is high, as the insurance portion of the bill would otherwise be substantial.
To ensure you receive the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as summary bills often obscure individual charges and potential errors. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if paid upfront. When evaluating the value of this service, compare the facility's rates against the Medicare benchmark of $106.81; the commercial negotiated rate represents a significant markup above this federal baseline, highlighting the importance of verifying your specific plan's allowed amount and deductible status before scheduling the procedure.