Ultrasound, thyroid and neck
Facility: Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $972
- Cash Discount Price: $1,767
- vs. Medicare Baseline: 9.10x 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 910% of the Medicare baseline (a markup of 810%). 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 | $508 | 476% |
| Tricare | $884 | 828% |
| Humana | $884 | 828% |
| Medicare (plans) | $892 | 835% |
| Ambetter / Centene | $972 | 910% |
| Coventry - All Other Plans | $1,591 | 1490% |
| Health Partners Of Kansas - All Plans | $1,679 | 1572% |
| Preferred Healthcare-All Plans | $1,679 | 1572% |
| Wppa/Providers Care-All Plans | $2,474 | 2316% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Memorial Hospital in Abilene, KS, the cash price is $1,767.00, which matches the facility's cash median. While the hospital's negotiated rates for in-network payers range from $508 to $2,474, the cash price is notably higher than the lowest negotiated rates offered by insurers like Blue Cross Blue Shield ($508) and Tricare ($884). However, for patients with high-deductible plans, paying the full cash price of $1,767.00 upfront may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these can significantly reduce the final bill.
This service is provided by a Critical Access Hospital in a rural setting, where pricing dynamics can differ from urban centers. The Medicare benchmark for this procedure is $106.81, which serves as a baseline for evaluating commercial rates; the cash price represents a significant markup over this federal standard. While the facility's facility rating is 2, the primary focus for consumers should remain on understanding the specific financial terms. If you receive an itemized bill, ensure it breaks down the exact CPT codes to avoid errors or unbundled charges, and always verify your deductible status before scheduling to prevent unexpected out-of-pocket costs.