Ultrasound, thyroid and neck
Facility: Logan County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $715
- Cash Discount Price: $200
- vs. Medicare Baseline: 6.69x 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 669% of the Medicare baseline (a markup of 569%). 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 |
|---|---|---|
| Humana | $424 | 397% |
| Blue Cross Blue Shield | $481 | 450% |
| Health Partners - All Plans | $950 | 889% |
| Medicaid / KanCare | $1,000 | 936% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Logan County Hospital in Oakley, KS, the facility's cash median price is $200.00, which is significantly lower than the negotiated rates paid by major payers such as Humana ($424), Blue Cross Blue Shield ($481), and Health Partners ($950). This price difference highlights the potential savings for patients with high-deductible plans who may not have met their out-of-pocket limits; in such cases, paying the cash price directly can result in a lower total cost than the insurance negotiated rate. Additionally, patients should inquire about "prompt-pay" discounts, which are upfront fee reductions typically ranging from 20% to 50% offered by hospitals to those who settle their bill immediately, effectively bypassing the administrative costs associated with insurance claims processing.
When evaluating the cost of this service, it is important to compare the facility's pricing against objective benchmarks rather than the hospital's inflated chargemaster list. The Medicare amount for this procedure is $106.81, and the facility's cash rate of $200.00 represents a markup of 6.7 times the Medicare benchmark, which aligns with the typical range where fair pricing is defined as 120% to 150% of the Medicare rate. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that balance billing is generally prohibited for emergency care under the No Surprises Act, though unexpected charges can still occur from out-of-network ancillary services. To ensure accuracy and avoid errors, consumers should request a full itemized bill before