Ultrasound, thyroid and neck
Facility: Community Memorial Healthcare, Inc.
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $454
- Cash Discount Price: $747
- vs. Medicare Baseline: 4.25x 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 425% of the Medicare baseline (a markup of 325%). 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 | $344 - $560 | 322% |
| UnitedHealthcare | $427 | 400% |
| Blue Cross Blue Shield | $481 | 450% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Community Memorial Healthcare, Inc., the cash price is $747.00, which matches the facility's median negotiated rate. This cash price is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 4.3 times the federal rate. While the facility is a Critical Access Hospital in Marysville, KS, the data provided does not include specific county or state average comparisons to contextualize this pricing relative to other providers in the region.
Patients should be aware that commercial insurance negotiated rates, such as the $427 to $560 range seen with Aetna and UnitedHealthcare, often exceed the cash price due to administrative costs and contract structures. If you have a high-deductible plan, paying the cash price of $747.00 upfront may be more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if your deductible is not yet met. To secure the best possible rate, you should verify your specific plan's allowed amount before scheduling and explicitly request a "self-pay" or "prompt-pay" discount from the billing department, as these programs can reduce the final bill by 20% to 50% when paid in full.