Ultrasound, thyroid and neck
Facility: Rawlins County Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $481
- Cash Discount Price: $472
- vs. Medicare Baseline: 4.50x 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 450% of the Medicare baseline (a markup of 350%). 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 | $130 - $835 | 122% |
| Blue Cross Blue Shield | $481 | 450% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck performed at Rawlins County Health Center in Atwood, Kansas, the cash median price is $472.00, which is lower than the facility's gross charge of $555.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance negotiated rates can sometimes exceed cash prices. In this case, UnitedHealthcare's negotiated rate ranges from $130 to $835 across four plans, and Blue Cross Blue Shield's single plan negotiates at $481.00. If you have a high-deductible plan that has not yet met your deductible, paying the cash price of $472.00 upfront could result in immediate savings compared to the insurance negotiated rate of $481.00, provided you do not incur additional out-of-pocket costs.
To ensure you are not overcharged, it is important to distinguish between the facility's gross charges and the actual amounts billed to insurance. The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing markup; the cash rate of $472.00 represents a significant increase over this federal standard. If you receive a bill from an out-of-network provider or encounter unexpected charges, you may be subject to balance billing, where the provider bills you for the difference between their full rate and what your insurance allowed. To protect yourself, always request an itemized bill before paying and dispute any summary bills that do not show specific CPT codes. Additionally, ask the billing department about prompt-pay discounts, which can reduce your total cost if