Ultrasound, thyroid and neck
Facility: Bob Wilson Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $1,017
- Cash Discount Price: $498
- vs. Medicare Baseline: 9.52x 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 952% of the Medicare baseline (a markup of 852%). 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 |
|---|---|---|
| Centura Employee Plan | $205 | 192% |
| Kansas Health | $398 | 373% |
| UnitedHealthcare | $398 - $1,038 | 373% |
| Humana | $398 | 373% |
| Aetna | $398 - $996 | 373% |
| Medicare (plans) | $398 | 373% |
| Blue Cross Blue Shield | $642 | 601% |
| Multiplan | $1,120 - $1,158 | 1049% |
| Health Partners Of Kansas | $1,170 | 1095% |
| Wppa | $1,182 | 1107% |
Consumer Guidance & Cost Commentary
For the CPT code 76536 (Ultrasound, thyroid and neck) at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's cash median rate is $498.00, which is significantly lower than the negotiated rates paid by most insurance plans. While the hospital's cash price is well below the gross charge of $1,245.00, many commercial payers negotiate rates ranging from $398 to over $1,100, often exceeding the cash amount. This pricing structure highlights a common billing dynamic where paying out-of-pocket upfront can result in substantial savings compared to having insurance process the claim, particularly for patients with high deductibles or those whose specific plan allows amounts exceed the facility's cash price.
To maximize financial protection, patients should verify their specific plan's allowed amount before scheduling, as some insurers may pay less than the cash rate due to administrative overheads. Additionally, patients should request a prompt-pay discount or self-pay rate directly from the hospital prior to receiving care, as these discounts can further reduce the final bill. If a balance bill arises from an out-of-network service, patients are protected under the No Surprises Act and should dispute the charge in writing rather than paying immediately. Finally, requesting an itemized bill is essential to identify any unbundled codes or services not rendered, ensuring the patient only pays for the actual ultrasound procedure performed.