Ultrasound, thyroid and neck
Facility: Rooks County Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $725
- Cash Discount Price: $604
- vs. Medicare Baseline: 6.79x 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 679% of the Medicare baseline (a markup of 579%). 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 |
|---|---|---|
| Celtic Mcr Adv | $379 | 355% |
| Veterans Admin - All Plans | $379 | 355% |
| Tricare | $379 | 355% |
| Celtic Comm - All Other Plans | $417 | 390% |
| Blue Cross Blue Shield | $481 | 450% |
| Aetna | $725 | 679% |
| Preferred Benefits Admin | $725 | 679% |
| UnitedHealthcare | $725 | 679% |
| Preferred Hlthcare - All Other Plans | $765 | 716% |
| Health Partners - All Plans | $765 | 716% |
| Healthy Blue Mcaid - All Plans | $806 | 755% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Rooks County Health Center in Plainville, Kansas, the facility's cash price is $604.00, which is lower than the state average of $725.00. While many insurance plans negotiate rates that exceed this cash price—such as Aetna, UnitedHealthcare, and Preferred Healthcare all paying $725.00—patients with high-deductible plans may find paying the cash rate directly more cost-effective. Because the facility is a government-owned Critical Access Hospital, it is important to verify if your specific plan qualifies for the negotiated rate before scheduling, as some commercial payers may still apply balance billing if they do not have a contract with the facility.
To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you receive a balance bill for an out-of-network service, remember that the No Surprises Act generally protects you from paying the difference between the facility's chargemaster and your insurance allowed amount for emergency or non-emergency care at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can reduce the final cost by 20% to 50% if you settle the account upfront, bypassing the administrative costs associated with insurance claims processing.