Ultrasound, thyroid and neck
Facility: Fredonia Regional Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $632
- Cash Discount Price: $702
- vs. Medicare Baseline: 5.92x 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 592% of the Medicare baseline (a markup of 492%). 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 | $347 - $481 | 325% |
| Aetna | $358 - $632 | 335% |
| Veterans Programs - All Plans | $358 | 335% |
| UnitedHealthcare | $358 - $632 | 335% |
| Cigna | $632 | 592% |
| Reserve National-All Plans | $632 | 592% |
| Meritain-All Plans | $632 | 592% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck performed at Fredonia Regional Hospital in Kansas, the cash price is $702.00, which matches the facility's median negotiated rate of $632.00. This cash price is significantly higher than the Medicare benchmark of $106.81, reflecting the standard markup for commercial services. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative costs and contract structures. In this specific case, the cash price is the lowest available option compared to the negotiated amounts paid by various insurers, which range from $347 to $632 depending on the plan.
To minimize out-of-pocket costs, patients should verify if their specific insurance plan has a deductible that has already been met, as paying the full negotiated rate may be unnecessary if the deductible remains. Additionally, since the cash price of $702.00 is higher than the median negotiated rate, it is important to confirm whether the facility offers "self-pay" or "prompt-pay" discounts for upfront payment, which can sometimes reduce the final bill. Patients are advised to request an itemized billing audit before finalizing payment to ensure no errors or unbundled charges are included, as over 80% of hospital bills contain discrepancies. Always compare the facility's rates against state averages and seek written confirmation of any discounts before scheduling services.