Ultrasound, thyroid and neck
Facility: Hodgeman County Health Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $523
- Cash Discount Price: $594
- vs. Medicare Baseline: 4.90x 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 490% of the Medicare baseline (a markup of 390%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $457 - $481 | 428% |
| UnitedHealthcare | $476 - $706 | 446% |
| Medicaid / KanCare | $476 - $743 | 446% |
| Humana | $476 | 446% |
| Triwest - All Plans | $476 | 446% |
| Aetna | $594 | 556% |
| First Health - All Plans | $669 | 626% |
| Health Partners - All Plans | $706 | 661% |
| Wppa (Provdrscare) - All Plans | $706 | 661% |
Consumer Guidance & Cost Commentary
For the CPT code 76536, "Ultrasound, thyroid and neck," the Hodgeman County Health Center in Jetmore, KS, has a gross charge of $743.00. This represents a 4.9% markup compared to the Medicare benchmark of $106.81, which serves as the objective baseline for fair pricing. While the facility's cash median price is $594.00, commercial insurance payers negotiate rates that range from $457 to $743 depending on the plan. For instance, Blue Cross Blue Shield offers a low end of $457, whereas UnitedHealthcare and Medicaid/KanCare have negotiated rates starting at $476 but can reach up to $743. Patients with high-deductible plans may find the cash price of $594.00 more affordable than their specific insurance negotiated rate, provided they have not yet met their deductible or are paying out-of-pocket.
To secure the lowest possible cost, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payments can bypass costly insurance billing cycles and administrative overhead. It is important to verify the exact allowed amount for your specific plan rather than assuming in-network status guarantees the best price, as negotiated rates vary significantly across the nine payers listed. Additionally, if you receive a bill after using insurance, request a full itemized audit to ensure no errors or unbundled charges exist, as over 80% of hospital bills contain discrepancies. Given that the facility is a Critical Access Hospital with government-local ownership, comparing the final allowed amount to the Medicare benchmark of $