Ultrasound, thyroid and neck
Facility: Clay County Medical Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $158
- Cash Discount Price: $170
- vs. Medicare Baseline: 1.48x 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.
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 |
|---|---|---|
| Multiplan- All Plans | $26 - $530 | 24% |
| UnitedHealthcare | $33 - $530 | 31% |
| Aetna | $53 - $519 | 50% |
| Wppa/Providrs Care- All Plans | $53 - $519 | 50% |
| Health Partners - All Plans | $54 - $530 | 51% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Clay County Medical Center in Clay Center, KS, the cash median price is $170.00, which matches the gross charge and the Medicare benchmark of $106.81. While the facility is a Critical Access Hospital with government local ownership, the negotiated rates paid by major payers like UnitedHealthcare and Aetna range from $33 to $530, significantly higher than the cash price. This disparity highlights the importance of understanding that in-network insurance rates often exceed cash prices due to administrative costs and contract structures; patients with high-deductible plans may find paying the $170.00 cash median more cost-effective than relying on insurance, which could result in higher out-of-pocket expenses if their deductible is not met.
To minimize potential financial exposure, consumers should proactively request a prompt-pay discount or self-pay rate before scheduling, as these upfront payments can bypass costly insurance billing cycles and administrative fees. Additionally, if you receive a bill, always demand a full itemized audit rather than accepting a summary invoice, since over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Given that balance billing protections exist under the No Surprises Act for emergency care and non-emergency services at in-network facilities, patients should verify their network status and dispute any unexpected charges immediately rather than paying surprise bills out of fear of credit damage.