Ultrasound, thyroid and neck
Facility: Sheridan County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $662
- Cash Discount Price: $782
- vs. Medicare Baseline: 6.20x 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 620% of the Medicare baseline (a markup of 520%). 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 |
|---|---|---|
| Celtic Insurance | $473 | 443% |
| Blue Cross Blue Shield | $662 | 620% |
| UnitedHealthcare | $743 | 696% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Sheridan County Hospital in Hoxie, KS, the cash price is $782.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, reflecting the facility's status as a Critical Access Hospital with government-local ownership. While the facility's negotiated rate of $662.00 is lower than the cash price, it is still above the state average, meaning patients with high-deductible plans might find paying the full cash price of $782.00 more cost-effective if their insurance negotiated rate exceeds this amount. It is important to note that the facility does not appear to have a specific self-pay or prompt-pay discount listed in this data, so patients should verify current cash rates directly with the hospital before scheduling to ensure they are receiving the best possible price.
The data indicates that this service is covered by three payers, including Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare, with negotiated rates ranging from $473 to $743. However, the median negotiated rate of $662.00 is notably lower than the gross charge of $782.00, demonstrating the impact of insurance contracts on final costs. Under the No Surprises Act, patients should be aware that balance billing for out-of-network services at in-network facilities is generally prohibited, though they should still review their itemized bills carefully to ensure no unbundled codes or services not rendered are included. If a patient receives a bill that appears to include charges beyond the negotiated rate, they should request a formal itemized audit to identify