Ultrasound, thyroid and neck
Facility: Stevens County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $716
- Cash Discount Price: $809
- vs. Medicare Baseline: 6.70x 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 670% of the Medicare baseline (a markup of 570%). 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 | $299 - $300 | 280% |
| Aetna | $308 - $810 | 288% |
| Blue Cross Blue Shield | $457 - $481 | 428% |
| First Health - All Plans | $727 - $729 | 681% |
| Wppa - All Plans | $768 - $770 | 719% |
| Medicaid / KanCare | $808 - $810 | 756% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Stevens County Hospital in Hugoton, Kansas, the cash price is $809.00, which matches the facility's gross charge and median paid amount. This cash rate is significantly higher than the state average of $514.00, though it remains comparable to the Medicare benchmark of $106.81 when adjusted for the facility's specific cost structure. Patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rates exceed this amount, as paying upfront can sometimes result in lower out-of-pocket costs. It is important to note that while the facility is a Critical Access Hospital owned by the local government, the cash rate does not reflect any potential prompt-pay discounts, which could reduce the final bill by 20% to 50% if paid in full within 30 days.
Insurance coverage varies widely across the six payers listed for this service, with Humana plans covering $299 to $300 and Medicaid/KanCare plans covering $808 to $810. The median negotiated rate across all payers is $716.00, which is lower than the cash price but higher than the state average of $514.00. Because the facility is in-network for these plans, the No Surprises Act generally protects patients from balance billing for out-of-network services at this location, though patients should still verify their specific deductible status before scheduling. To ensure the most accurate pricing, consumers are encouraged to request an itemized bill and confirm whether any prompt-pay discounts apply prior to check-in, rather than waiting to negotiate after receiving a summary invoice.