Ultrasound, thyroid and neck
Facility: Mercy Hospital Columbus
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $652
- Cash Discount Price: $584
- vs. Medicare Baseline: 6.10x 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 610% of the Medicare baseline (a markup of 510%). 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 | $70 - $652 | 66% |
| Humana | $70 - $853 | 66% |
| Blue Cross Blue Shield | $91 - $652 | 85% |
| UnitedHealthcare | $91 - $745 | 85% |
| Medicare (plans) | $100 - $678 | 94% |
| Insurance System Inc Contracted [320465] | $386 | 361% |
| Health Systems Inc Contracted [320174] | $386 | 361% |
| Administrative Payor Contracted [320005] | $404 | 378% |
| Indian Health Service Contracted [320198] | $652 | 610% |
| Kindful Hospice [20434] | $652 | 610% |
| Cherokee Nation Health Serv Contracted [320066] | $652 | 610% |
| Dept Of Veteran Affairs Contracted [320106] | $652 | 610% |
| Mercy Hospice Okc [20252] | $652 | 610% |
| Pace Of The Ozarks Contracted [320518] | $652 | 610% |
| Centurion Of Missouri [20459] | $652 | 610% |
| Aetna | $652 - $808 | 610% |
| Kindful Hospice Contracted [320434] | $652 | 610% |
| Home State Health Plan Contracted [320187] | $652 | 610% |
| Novasys Contracted [320285] | $652 | 610% |
| Halo Hcr Inc Hospice [20432] | $652 | 610% |
| Globalhealth Contracted [320145] | $652 | 610% |
| Cross Timbers Hospice [20098] | $652 | 610% |
| Ambetter / Centene | $652 | 610% |
| Elara Caring Aspire Hospice [20433] | $652 | 610% |
| Medical Associates Health Contracted [320444] | $652 | 610% |
| Halo Hcr Inc Hospice Contracted [320432] | $652 | 610% |
| Mercy Mgd Behavioral Health Contracted [320259] | $652 | 610% |
| Cigna | $652 | 610% |
| Provider Partners Health Plans Contracted [320450] | $652 | 610% |
| Qual Choice Contracted [320325] | $652 | 610% |
| Tricare | $654 | 612% |
| Healthscope Contracted [320182] | $692 | 648% |
| Workers Comp [20426] | $718 - $763 | 672% |
| United Medical Resources Contracted [320454] | $745 - $853 | 698% |
| Medica Contracted [320239] | $805 | 754% |
| Preferred Health Plan Contracted [320522] | $808 | 756% |
| Usa Managed Care Org Contracted [320429] | $808 | 756% |
| First Health Contracted [320128] | $808 | 756% |
| Federal Medical Center Contracted [320127] | $808 | 756% |
| American Healthcare Alliance Contracted [320020] | $808 | 756% |
| Mercy Benefit Admin Contracted [320251] | $808 - $853 | 756% |
| Healthlink Contracted [320179] | $808 - $853 | 756% |
| Aither Health Contracted [320449] | $853 | 799% |
| Yuzu Health Contracted [320521] | $853 | 799% |
| Benefit Management Contracted [320052] | $853 | 799% |
| Edison Health Solutions Contracted [320502] | $853 | 799% |
| Ppo Plus Contracted [320310] | $853 | 799% |
| Reflect Health Contracted [320492] | $853 | 799% |
| 90 Degree Benefits Contracted [320436] | $853 | 799% |
| Private Health Care Systems Contracted [320320] | $853 | 799% |
| Imagine 360 Contracted [320494] | $853 | 799% |
| Auxiant Contracted [320462] | $853 | 799% |
| Show-Me Health Administrators Contracted [320483] | $853 | 799% |
| Point C Contracted [320238] | $853 | 799% |
| Ebms Contracted [320493] | $853 | 799% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Mercy Hospital Columbus, the facility's cash price of $584.00 is lower than the median negotiated rate of $652.00 paid by most insurers, including Medicaid/KanCare, Humana, and Blue Cross Blue Shield. While the gross charge listed is $898.00, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount due to administrative overhead and contract structures. Because this facility is a Critical Access Hospital in Kansas, the cash rate of $584.00 is significantly lower than the state average for this procedure, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible out-of-pocket rate.
The Medicare benchmark for this service is $106.81, which serves as a baseline for evaluating the facility's pricing; the cash price of $584.00 represents a markup of approximately 546% over the Medicare rate, which is higher than the typical fair pricing range of 120% to 150% of Medicare. However, the median negotiated rate of $652.00 is still substantially lower than the gross charge, and patients should avoid accepting summary bills that obscure individual line items. To protect against unexpected costs, consumers should request a full itemized CPT-coded bill to verify that no services were unbundled or that charges for cancelled tests were included, and they should dispute any balance bills immediately if they arise from out-of-network ancillary services, as federal protections under the