Ultrasound, thyroid and neck
Facility: Medicine Lodge Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $672
- Cash Discount Price: $708
- vs. Medicare Baseline: 6.29x 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 629% of the Medicare baseline (a markup of 529%). 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 |
|---|---|---|
| Tricare | $567 | 531% |
| Humana | $644 | 603% |
| Aetna | $655 - $708 | 613% |
| UnitedHealthcare | $672 | 629% |
| Hpk-All Plans | $672 | 629% |
| Medicaid / KanCare | $708 | 663% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck performed at Medicine Lodge Memorial Hospital in Medicine Lodge, Kansas, the cash price is $708.00, which matches the facility's gross charge and the highest negotiated rate paid by Aetna. While the median negotiated rate across all payers is $672.00, patients should note that commercial insurance rates often include administrative overhead and contract premiums that can exceed the cash price. In this specific case, paying cash directly may result in a lower out-of-pocket cost compared to using insurance if your plan has a high deductible or if the negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing costly claims processing fees.
This service is benchmarked against the federal Medicare rate of $106.81, indicating that the facility's pricing reflects a significant markup typical of commercial healthcare delivery. The facility, a Critical Access Hospital owned by a Government Hospital District, has six distinct payer contracts, with rates ranging from $567 for Tricare up to $708 for Aetna. Because Medicare rates serve as the objective baseline for true cost, comparing the $708 cash price to the $106.81 Medicare amount highlights the substantial difference between government-set costs and market rates. Consumers are encouraged to request an itemized bill to verify that no unbundled codes or services not rendered have inflated the total, ensuring that the final amount aligns with the negotiated or cash rates provided in the transparency data.