Ultrasound, thyroid and neck
Facility: Republic County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $598
- Cash Discount Price: $488
- vs. Medicare Baseline: 5.60x 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 560% of the Medicare baseline (a markup of 460%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $552 | 517% |
| Meritain-All Plans | $585 | 548% |
| Aetna | $585 | 548% |
| UnitedHealthcare | $598 | 560% |
| First Health-All Plans | $618 | 579% |
| Midlands Choice-All Plans | $618 | 579% |
| Cigna | $618 | 579% |
Consumer Guidance & Cost Commentary
For the CPT code 76536, "Ultrasound, thyroid and neck," Republic County Hospital in Belleville, KS, lists a gross charge of $650.00. This amount is significantly higher than the facility's cash median of $488.00 and the median negotiated rate of $598.00 paid by insurance carriers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should note that commercial payers like Rural Carriers, Meritain, and Aetna have negotiated rates ranging from $552 to $598, which are still above the cash price. Given that cash-pay options can sometimes be more affordable than insurance negotiated rates for those with high-deductible plans, it is advisable to inquire directly with the hospital about self-pay or prompt-pay discounts before scheduling.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $488.00 represents a substantial increase over the Medicare amount, while the median negotiated rate of $598.00 reflects the administrative costs and contract dynamics inherent in commercial insurance billing. To ensure you are receiving the most accurate and transparent pricing, patients should request an itemized billing audit rather than accepting a summary bill, as detailed line-by-line statements help identify errors or unbundled codes that may inflate the total. Additionally, under federal protections such as the No Surprises Act, patients are shielded from balance billing for out-of-network services at in-network facilities, so it is important to verify your specific plan details and any applicable discounts prior to receiving