Ultrasound, thyroid and neck
Facility: Kiowa County Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $587
- Cash Discount Price: $561
- vs. Medicare Baseline: 5.50x 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 550% of the Medicare baseline (a markup of 450%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $481 - $587 | 450% |
| UnitedHealthcare | $529 - $660 | 495% |
| Health Partners Of Ks-All Plans | $581 | 544% |
| Medica Prime Mcare Cost-All Plans | $587 | 550% |
| Aetna | $587 | 550% |
| Celtic Comml Exchange-All Other Plans | $587 | 550% |
| Humana | $587 | 550% |
| Medicaid / KanCare | $660 | 618% |
| Providrs Care/Wppa-All Plans | $990 | 927% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Kiowa County Memorial Hospital in Greensburg, KS, the cash median price is $561.00, which is lower than the facility's gross charge of $660.00. While the hospital is a Critical Access Hospital owned by the local government, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare's negotiated range spans from $529 to $660, and Medicaid/KanCare is set at $660, meaning cash payment could result in immediate savings for those with high-deductible plans who have not yet met their out-of-pocket maximum.
When evaluating costs against benchmarks, it is important to compare rates to the Medicare amount of $106.81 rather than the hospital's gross list price, as the latter inflates the perceived value of discounts. The facility's cash rate of $561.00 represents a significant markup over the Medicare baseline, consistent with commercial pricing dynamics where negotiated rates can average 200% to 300% of Medicare amounts. To minimize costs, patients should verify their specific plan's allowed amount before scheduling, as some in-network carriers may negotiate lower rates than others, and they should explicitly request a "self-pay" or "prompt-pay" discount prior to check-in to avoid automatic claims submission that could void cash savings.