Ultrasound, thyroid and neck
Facility: Graham County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $516
- Cash Discount Price: $666
- vs. Medicare Baseline: 4.83x 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 483% of the Medicare baseline (a markup of 383%). 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 | $145 | 136% |
| UnitedHealthcare | $145 - $633 | 136% |
| Blue Cross Blue Shield | $476 | 446% |
| Medicare (plans) | $500 | 468% |
| Celtic Commercial-All Other Plans | $549 | 514% |
| Wppa (Providers Care)-All Plans | $633 | 593% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Graham County Hospital in Hill City, Kansas, the cash price is $666.00, which matches the facility's median negotiated rate. This service is significantly more expensive than the state average, with the cash price being 4.8 times the Medicare benchmark of $106.81. While commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $145 to $633, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the insurance allowed amounts can sometimes be higher than what they would pay out-of-pocket. It is important to note that the facility is a Critical Access Hospital owned by the local government, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially lower the final cost.
The data indicates that while Medicaid/KanCare has a fixed rate of $145, other payers show a wide variance, with UnitedHealthcare's rates spanning from $145 to $633 across three different plans. Because commercial rates are often inflated by administrative processing and contract dynamics, the cash price of $666.00 serves as a useful baseline for comparison. If a patient receives care from an out-of-network provider, they could face balance billing for the difference between the provider's full charge and the insurance allowed amount, though the No Surprises Act protects patients from such surprise bills for emergency services at in-network facilities. To ensure accuracy, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over 80%