Ultrasound, thyroid and neck
Facility: Ashland Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $667
- Cash Discount Price: $534
- vs. Medicare Baseline: 6.24x 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 624% of the Medicare baseline (a markup of 524%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $223 | 209% |
| Compalliance-All Plans | $534 | 500% |
| Health Partners Of Kansas-All Plans | $567 | 531% |
| Multiplan-All Plans | $654 | 612% |
| Healthy Blue Mcr Adv - All Other Plans | $667 | 624% |
| Health Choice-All Plans | $667 | 624% |
| UnitedHealthcare | $667 | 624% |
| Medicare (plans) | $667 | 624% |
| Medicaid / KanCare | $667 | 624% |
| Medica Mcare - All Plans | $667 | 624% |
| Aetna | $667 | 624% |
| Providers Care (Wppa)-All Plans | $1,001 | 937% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Ashland Health Center in Ashland, KS, the facility's cash median rate is $534.00, which is lower than the negotiated rates paid by most insurance payers. While the facility's negotiated rate of $667.00 matches the gross charge, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds this amount. It is important to note that the cash price of $534.00 is significantly lower than the Medicare benchmark of $106.81, indicating a substantial markup relative to the federal government's cost-based reimbursement standard.
When comparing pricing to regional benchmarks, the facility's cash rate of $534.00 is notably higher than the state average for this procedure, though specific county averages were not provided in the data. The facility, a Critical Access Hospital owned by a voluntary non-profit, lists a median negotiated rate of $667.00, which aligns with the gross charge and the rates charged by major payers such as UnitedHealthcare and Aetna. Patients should be aware that while the facility offers a cash rate, they must explicitly request a "self-pay" or "prompt-pay" discount before scheduling to ensure they receive the lowest possible price, as billing systems may default to insurance processing if coverage is on file.