Ultrasound, thyroid and neck
Facility: Smith County Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $658
- Cash Discount Price: $700
- vs. Medicare Baseline: 6.16x 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 616% of the Medicare baseline (a markup of 516%). 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 | $476 | 446% |
| Medicaid / KanCare | $490 - $700 | 459% |
| Multiplan-All Plans | $630 | 590% |
| Wppa-All Plans | $658 | 616% |
| Midlands Choice-All Plans | $665 | 623% |
| Health Partners Of Ks Ppo-All Plans | $665 | 623% |
| UnitedHealthcare | $665 | 623% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $700, which matches the facility's gross charge and the median amount paid by Medicaid plans. This rate is significantly higher than the Medicare benchmark of $106.81, reflecting a markup common in commercial billing where negotiated rates often exceed 200% of the federal baseline. While the facility is a government-owned Critical Access Hospital, patients with high-deductible plans may find the cash price more affordable than the negotiated rate of $658 if their insurance has not yet met their deductible, as the administrative load of insurance processing can inflate the final bill.
To secure the best possible rate, patients should verify their specific plan's negotiated amount before scheduling, as in-network rates vary widely even within the same county. The data shows a range of negotiated payments from $476 to $700 across different payers, indicating that some commercial plans may pay less than the cash price. Before finalizing payment, it is advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, patients should request a full itemized bill to ensure no errors or unbundled charges exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.