Ultrasound, thyroid and neck
Facility: Cloud County Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $1,679
- Cash Discount Price: $1,237
- vs. Medicare Baseline: 15.72x 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 1572% of the Medicare baseline (a markup of 1472%). 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 |
|---|---|---|
| Aetna | $1,591 - $1,644 | 1490% |
| Health Partners - All Plans | $1,679 | 1572% |
| Mpi-All Plans | $1,679 | 1572% |
| Pponext-All Plans | $1,679 | 1572% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Cloud County Health Center in Concordia, KS, the facility's cash price of $1,237 is lower than the median negotiated rate of $1,679 paid by major payers like Aetna and Health Partners. This difference highlights a common billing dynamic where commercial insurance contracts often result in higher out-of-pocket costs for patients compared to self-pay options, particularly for those with high-deductible plans. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify if their specific insurance plan has a deductible that would require them to pay the full negotiated amount before any coverage applies.
To ensure you are not overcharged, it is advisable to request a detailed itemized bill before finalizing payment, as summary invoices can sometimes obscure individual service costs or unbundled charges. Additionally, if you have received a post-insurance bill, you may be eligible for a prompt-pay discount by paying the balance in full upfront, which can significantly reduce the total amount owed. Given that the facility's cash rate is notably lower than the commercial negotiated rates, contacting the billing department directly to confirm self-pay or prompt-pay discounts before scheduling your appointment is the most effective way to minimize your financial burden.