Ultrasound, thyroid and neck
Facility: Wamego Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $66
- Cash Discount Price: $337
- vs. Medicare Baseline: 0.62x 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.
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 |
|---|---|---|
| UnitedHealthcare | $22 - $91 | 21% |
| Medicaid / KanCare | $23 - $94 | 22% |
| Aetna | $23 - $94 | 22% |
| Providrs Care | $36 - $148 | 34% |
| Tricare | $99 | 93% |
| Blue Cross Blue Shield | $631 - $665 | 591% |
Consumer Guidance & Cost Commentary
For the CPT code 76536, "Ultrasound, thyroid and neck," Wamego Health Center in Wamego, KS, lists a gross charge of $843.00. The facility's cash median rate is $337.00, which is significantly lower than the negotiated rates paid by major payers such as Blue Cross Blue Shield ($631.00 to $665.00) and Medicaid/KanCare ($23.00 to $94.00). When comparing this service to the Medicare benchmark of $106.81, the facility's cash price represents a 316% markup, while the highest negotiated rate exceeds the Medicare amount by over six times. Patients with high-deductible plans may find the cash price more affordable than their insurance allowed amount, provided they qualify for the facility's self-pay or prompt-pay discounts.
To avoid unexpected costs, consumers should request an itemized billing audit before paying any balance bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If a patient receives care from an out-of-network provider at this in-network facility, they may be subject to balance billing for the difference between the chargemaster rate and the insurance allowed amount, though the No Surprises Act protects against this for emergency and non-emergency services. It is crucial to verify the specific allowed amount with the insurer prior to scheduling and to explicitly ask for a waiver of insurance submission if paying cash directly to ensure the prompt-pay discount is applied correctly.