Ultrasound, thyroid and neck
Facility: Lane County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $843
- Cash Discount Price: $843
- vs. Medicare Baseline: 7.89x 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 789% of the Medicare baseline (a markup of 689%). 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 |
|---|---|---|
| UnitedHealthcare | $759 - $843 | 711% |
| Aetna | $759 - $801 | 711% |
| Healthy Blue Mcr Adv - All Other Plans | $843 | 789% |
| Healthy Blue Mcaid | $843 | 789% |
| Medicaid / KanCare | $843 - $927 | 789% |
| Wppa Providers-All Plans | $1,264 | 1183% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Lane County Hospital in Dighton, KS, the cash price is $843.00, which matches the median negotiated rate across all six payers listed, including UnitedHealthcare, Aetna, and Medicaid/KanCare. While the facility is a Critical Access Hospital with government ownership, the cash price aligns with the median paid amount of $843.00, suggesting that paying out-of-pocket may be the most cost-effective option for patients with high-deductible plans or those without insurance, as the insurance negotiated rates do not exceed the cash price. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated amount may be unnecessary if the insurance has not yet met its out-of-pocket threshold.
It is important to note that the Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup. Although the commercial rates are significantly higher than the Medicare amount, they remain consistent with the facility's cash pricing, avoiding the potential for balance billing that can occur with out-of-network providers. To ensure you receive the best possible rate, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the $843.00 cost. Additionally, if you receive an itemized bill, request a full line-by-line audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected to lower your final charge.