Ultrasound, thyroid and neck
Facility: Clara Barton Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $568
- Cash Discount Price: $442
- vs. Medicare Baseline: 5.32x 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 532% of the Medicare baseline (a markup of 432%). 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 |
|---|---|---|
| 6 Degrees Health - All Plans | $442 | 414% |
| Blue Cross Blue Shield | $476 | 446% |
| Wppa-All Plans | $505 | 473% |
| Phcs - All Plans | $568 | 532% |
| UnitedHealthcare | $568 | 532% |
| Aetna | $568 | 532% |
| Hlth Partners Of Ks-All Plans | $581 | 544% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Clara Barton Hospital in Hoisington, KS, the cash median price is $442.00, which is lower than the facility's negotiated rates of $568.00 and the median paid amount of $473.00. This price transparency report indicates that paying cash directly can sometimes be more cost-effective than using insurance, particularly for patients with high-deductible plans where the insurance negotiated rate exceeds the cash price. While the facility's cash rate is significantly lower than its gross charge of $631.00, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to ensure they are receiving the lowest possible rate.
The facility's pricing is evaluated against federal benchmarks, showing a variance of 5.3% compared to the Medicare amount of $106.81. It is important to note that commercial negotiated rates often include administrative costs and contract dynamics that can inflate the baseline price beyond the true cost of care represented by Medicare. If you receive a bill that includes charges for out-of-network services, such as specific lab tests or ancillary procedures, you may be subject to balance billing for the difference between the allowed amount and the full chargemaster rate. However, the No Surprises Act protects patients from these surprise bills for emergency care and non-emergency services provided at in-network facilities, and you should dispute any unexpected balance bills immediately rather than accepting summary invoices that obscure individual line items.