Ultrasound, thyroid and neck
Facility: Morris County Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $469
- Cash Discount Price: $581
- vs. Medicare Baseline: 4.39x 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 439% of the Medicare baseline (a markup of 339%). 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $64 | 60% |
| Va Ccn-All Plans | $378 | 354% |
| Blue Cross Blue Shield | $378 - $481 | 354% |
| Coventry Mcr | $378 | 354% |
| Choice Care Mcr Adv-All Plans | $378 | 354% |
| UnitedHealthcare | $378 - $968 | 354% |
| Cigna | $700 | 655% |
| Aetna | $867 | 812% |
| Multiplan-All Plans | $871 | 815% |
| Coventry Comm-All Other Plans | $871 | 815% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure covering the thyroid and neck at Morris County Hospital in Council Grove, KS, the facility's cash median rate of $581.00 is notably higher than the state average for this service. While the Medicare benchmark of $106.81 serves as the objective baseline for evaluating pricing markups, commercial negotiated rates vary significantly across payers, ranging from a low of $378 to a high of $968. Patients with high-deductible plans may find the cash price more advantageous than their insurance negotiated rates, which can sometimes exceed the cash amount due to administrative overhead and contract dynamics. It is important to verify your specific plan's allowed amount before scheduling, as assuming in-network status guarantees the lowest price is a common pitfall; some facilities charge substantially more than others for the same code.
To optimize costs, patients should proactively inquire about self-pay or prompt-pay discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims processing. Although the facility is a government-owned Critical Access Hospital, the gross charge of $968.00 represents the full list price, and commercial rates often average 200% to 300% of the Medicare rate, whereas fair pricing typically aligns closer to 120% to 150%. If you receive a bill after using insurance, request a detailed itemized audit to identify potential errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies. Always ensure you have a signed waiver preventing automatic claims submission if you choose to pay cash directly to secure the prompt