Ultrasound, thyroid and neck
Facility: Scott County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $957
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 8.96x 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 896% of the Medicare baseline (a markup of 796%). 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 | $60 - $1,010 | 56% |
| Humana | $446 | 418% |
| Blue Cross Blue Shield | $481 | 450% |
| Wppa | $638 - $1,200 | 597% |
| Aetna | $957 | 896% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Scott County Hospital, the negotiated rates paid by commercial payers range from $446 to $1,200, with a median negotiated amount of $957. This facility, a Critical Access Hospital in Scott City, KS, charges significantly higher than the state average, which is 9% above the Medicare benchmark of $106.81. While the gross charge is $1,063, patients should note that cash-pay rates are not listed for this service. However, because commercial negotiated rates often exceed cash prices, individuals with high-deductible plans may find it financially advantageous to pay the full cash price upfront if available, or to inquire directly with the hospital about "self-pay" or "prompt-pay" discounts that could reduce the final amount owed.
To ensure you are receiving the most accurate pricing, it is critical to request a full itemized bill rather than accepting a summary invoice, as hospitals may obscure individual costs under broad categories like "Laboratory." If you receive a bill, verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should confirm your deductible status before scheduling, as paying the negotiated rate without meeting your deductible may result in higher out-of-pocket costs than anticipated. Always compare the facility's specific rates against local averages and seek written confirmation of any discounts before finalizing payment.