Ultrasound, thyroid and neck
Facility: Kiowa District Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $644
- Cash Discount Price: $545
- vs. Medicare Baseline: 6.03x 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 603% of the Medicare baseline (a markup of 503%). 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 |
|---|---|---|
| Healthchoice-All Plans | $224 | 210% |
| Tricare | $266 | 249% |
| Blue Cross Blue Shield | $476 | 446% |
| UnitedHealthcare | $545 - $681 | 510% |
| Health Partners Of Ks-All Plans | $599 | 561% |
| Humana | $615 | 576% |
| Gbs Insurance - All Plans | $640 | 599% |
| Multiplan-All Plans | $640 | 599% |
| Medicare (plans) | $647 | 606% |
| Triwest-All Plans | $647 | 606% |
| Aetna | $647 | 606% |
| Medicaid / KanCare | $681 | 638% |
| Providers Care (Wppa)-All Plans | $1,022 | 957% |
| Liberty Healthshare-All Plans | $1,100 | 1030% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Kiowa District Hospital, the cash price is $545.00, which is lower than the median negotiated rate of $640.00 paid by most insurers. While the facility's cash rate is below the gross charge of $681.00, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows a higher negotiated rate than the cash price. It is important to ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can sometimes reduce the final bill by 20% to 50% by bypassing costly insurance claims processing.
This service is benchmarked against the federal Medicare rate of $106.81, which serves as the objective baseline for fair pricing. The facility's cash rate of $545.00 is significantly higher than the Medicare amount, reflecting the complexity of the procedure and local cost factors. Although specific county or state average data was not provided in the report, the facility is a Critical Access Hospital in Kiowa, KS, and its pricing is subject to federal protections under the No Surprises Act, which prevents balance billing for out-of-network services at in-network facilities. Patients should request an itemized bill to verify that all charges are accurate and that no unbundled codes or services not rendered have been included.