Ultrasound, thyroid and neck
Facility: Minneola District Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $515
- Cash Discount Price: $303
- vs. Medicare Baseline: 4.82x 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 482% of the Medicare baseline (a markup of 382%). 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 |
|---|---|---|
| Va Community Care Program-All Plans | $25 - $432 | 23% |
| UnitedHealthcare | $25 - $645 | 23% |
| Humana | $25 - $432 | 23% |
| Aetna | $88 - $645 | 82% |
| Providrs Care Network-All Plans | $88 - $548 | 82% |
| Medicaid / KanCare | $88 - $645 | 82% |
| Blue Cross Blue Shield | $481 | 450% |
| Corporate Plan Management-All Plans | $548 | 513% |
| Preferred Health Care (Coventry)-All Other Plans | $580 | 543% |
| Triwest-All Plans | $580 | 543% |
| Phc (Coventry) Leased Network | $613 | 574% |
| Health Partners Of Kansas-All Plans | $613 | 574% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Minneola District Hospital, the cash price is $303.00, which is lower than the facility's gross charge of $433.00. While the hospital's negotiated rates with major payers like UnitedHealthcare and Humana range from $25 to $645, these amounts often exceed the cash price, making self-pay a potentially more affordable option for patients with high-deductible plans. It is important to note that commercial rates can include administrative overhead that inflates the baseline price, and patients should verify their specific plan's deductible status before assuming insurance will result in lower out-of-pocket costs.
The facility's cash rate of $303.00 is significantly lower than the median negotiated rate of $515.00 and the median paid amount of $581.00. Although the data does not provide specific county or state average comparisons for this exact procedure, the substantial difference between the cash price and the median paid amount highlights the potential for balance billing if a patient has out-of-network coverage or if ancillary services are billed separately. To avoid unexpected costs, patients should request a prompt-pay discount or self-pay classification prior to scheduling, as paying upfront can bypass the costly claims processing cycle and reduce the final bill.