Ultrasound, thyroid and neck
Facility: Osborne County Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $746
- Cash Discount Price: $700
- vs. Medicare Baseline: 6.98x 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 698% of the Medicare baseline (a markup of 598%). 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 |
|---|---|---|
| UnitedHealthcare | $626 | 586% |
| Health Partners Of Kansas | $709 | 664% |
| Wppa | $783 | 733% |
| Blue Cross Blue Shield | $808 | 756% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Osborne County Memorial Hospital in Osborne, KS, the cash median price is $700.00, which is lower than the facility's gross charge of $824.00. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates for in-network payers range from $626 to $808, meaning some insurance plans may pay less than the cash price. This scenario highlights a key billing principle: if you have a high-deductible plan, paying the cash price of $700.00 upfront could save you money compared to your insurance paying a negotiated rate that is lower than your deductible threshold, especially since the facility does not appear to have a specific "median paid" figure in the data. Patients should verify their specific plan's allowed amount before scheduling to determine if the cash rate offers the best financial outcome.
To ensure you are not overcharged, it is critical to request a full itemized bill before paying, as summary bills often hide unbundled codes or services not rendered. If you receive a balance bill for the difference between the provider's chargemaster and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, since the facility offers prompt-pay discounts for upfront payment, you should explicitly ask the billing department about self-pay or prompt-pay rates prior to check-in to avoid automatic claims submission that could void any cash discounts. Always dispute any unexpected charges in writing to ensure accuracy, as over 80