Ultrasound, thyroid and neck
Facility: Trego County Lemke Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $531
- Cash Discount Price: $531
- vs. Medicare Baseline: 4.97x 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 497% of the Medicare baseline (a markup of 397%). 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 | $306 | 286% |
| Tricare | $331 | 310% |
| Va Ccn - All Plans | $388 | 363% |
| UnitedHealthcare | $388 - $625 | 363% |
| Aetna | $388 - $562 | 363% |
| Medicaid / KanCare | $388 - $625 | 363% |
| Ambetter / Centene | $426 | 399% |
| Health Partners - All Plans | $594 | 556% |
| Healthy Blue Mcaid - All Plans | $625 | 585% |
| Blue Cross Blue Shield | $657 | 615% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Trego County Lemke Memorial Hospital in Wakeeney, Kansas, the cash median price is $531.00, which is lower than the facility's negotiated rates for most major payers. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. For instance, UnitedHealthcare, Aetna, Medicaid/KanCare, and Blue Cross Blue Shield all have negotiated ranges that reach up to the gross charge of $625.00, whereas the cash price remains fixed at $531.00. This suggests that for patients with high-deductible plans or those without insurance, paying the cash median directly could result in lower out-of-pocket costs compared to standard insurance billing, provided the patient qualifies for a self-pay discount.
The facility's cash median of $531.00 aligns closely with the median negotiated rate of $531.00, indicating that the negotiated floor for many payers matches the cash price, but the ceiling varies significantly. For example, Humana, Tricare, and Healthy Blue Medicaid have fixed negotiated rates of $306.00, $331.00, and $625.00 respectively, while UnitedHealthcare's range spans from $388.00 to $625.00 across four plans. Patients should verify their specific plan's allowed amount before scheduling, as some commercial payers may allow amounts higher than the cash price. Additionally, because the facility is a Critical Access Hospital, patients should explicitly ask about "