Ultrasound, thyroid and neck
Facility: F W Huston Medical Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $478
- Cash Discount Price: $481
- vs. Medicare Baseline: 4.48x 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 448% of the Medicare baseline (a markup of 348%). 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 |
|---|---|---|
| Aetna | $451 | 422% |
| Humana | $475 | 445% |
| Blue Cross Blue Shield | $481 | 450% |
| Cigna | $511 | 478% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck performed at F W Huston Medical Center in Winchester, KS, the facility's cash price of $481.00 is notably lower than the median negotiated rates paid by commercial insurers, which range from $451 to $511 depending on the specific plan. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that commercial insurance contracts often include administrative overheads that can inflate the final allowed amount. In this instance, the cash price aligns closely with the median negotiated rate of $478.00, suggesting that paying out-of-pocket might not yield significant savings compared to using an in-network plan, though it remains a viable option for those with high deductibles or limited coverage.
When evaluating the cost against federal benchmarks, the facility's Medicare amount of $106.81 serves as the baseline for fair pricing, with commercial rates typically ranging from 200% to 300% of this figure. The facility's cash price of $481.00 represents a substantial markup over the Medicare rate, reflecting the specific cost dynamics of Critical Access Hospitals in the state of Kansas. To ensure you are receiving the best possible rate, it is recommended to contact the billing department directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before any insurance claims are even processed.