Ultrasound, thyroid and neck
Facility: Kingman Healthcare Center
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $88
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.82x 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 |
|---|---|---|
| Medicaid / KanCare | $88 | 82% |
| Healthy Blue | $88 | 82% |
| Aetna | $171 | 160% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Kingman Healthcare Center in Kansas, the median negotiated rate is $88.00, which aligns exactly with the lowest and highest rates reported by the three in-network payers: Medicaid/KanCare, Healthy Blue, and Aetna. This facility, a Critical Access Hospital in the Voluntary non-profit sector, does not offer a cash median rate in its current data, meaning patients without insurance coverage may face higher costs than the negotiated amounts. While commercial negotiated rates often exceed cash prices due to administrative overhead, the absence of a listed cash median here suggests that patients should verify if a self-pay or prompt-pay discount is available directly with the hospital before scheduling, as these upfront payment incentives can sometimes result in lower out-of-pocket costs than standard insurance billing.
The facility's pricing is significantly lower than the Medicare benchmark for this service, which is listed at $106.81. Under Medicare benchmarking principles, commercial rates are typically marked up between 200% and 300% of the Medicare rate, whereas fair pricing is generally defined as 120% to 150%. Since this facility's negotiated rate of $88.00 is well below the Medicare amount, it indicates a pricing structure that is more aligned with cost-based reimbursement than standard commercial markups. Patients should be aware that while balance billing is legally restricted for emergency care at in-network facilities by the No Surprises Act, it is crucial to request an itemized billing audit if unexpected charges appear, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered.