Ultrasound, thyroid and neck
Facility: Children'S Mercy South
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $62
- Cash Discount Price: $459
- vs. Medicare Baseline: 0.58x 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 |
|---|---|---|
| UnitedHealthcare | $23 - $1,230 | 22% |
| Healthy Blue | $25 - $273 | 23% |
| Cigna | $25 - $1,273 | 23% |
| Medicaid / KanCare | $25 - $70 | 23% |
| Home State Health | $31 - $240 | 29% |
| Healthlink | $34 - $1,611 | 32% |
| Wppa Providrs Care | $35 - $1,190 | 33% |
| Health Midwest Comprehensive Care | $37 - $1,192 | 35% |
| Quiktrip | $38 - $1,192 | 36% |
| American Healthcare Alliance | $38 - $1,556 | 36% |
| Blue Cross Blue Shield | $40 - $1,355 | 37% |
| Medica | $47 - $1,067 | 44% |
| Multiplan | $48 - $1,392 | 45% |
| Aetna | $49 - $1,245 | 46% |
| Wellfit/Centrus | $51 - $1,190 | 48% |
| Humana | $51 - $1,218 | 48% |
| Orscheln | $52 - $1,190 | 49% |
| Centivo | $52 - $1,190 | 49% |
| Nebraska Furniture Mart | $53 - $1,190 | 50% |
| Mercy Health | $59 - $1,373 | 55% |
| Coxhealth Network | $60 - $1,355 | 56% |
| Coventry Health Care Of Kansas | $62 - $1,355 | 58% |
| National Preferred Provider Network | $71 - $1,648 | 66% |
Consumer Guidance & Cost Commentary
For the ultrasound of the thyroid and neck at Children's Mercy South in Overland Park, KS, the cash price is $459.00, which is significantly lower than the facility's gross charge of $956.00. While Medicare reimburses $106.81 for this service, commercial payers negotiate rates that range from $23 to $1,648 depending on the insurance plan. For example, UnitedHealthcare pays as low as $23 but up to $1,230, whereas American Healthcare Alliance negotiates rates as high as $1,556. Because insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures, patients with high-deductible plans may save money by paying the cash price directly of $459.00, provided they verify their specific plan's allowed amount beforehand.
To ensure you receive the most accurate pricing, it is important to request an itemized bill before finalizing payment, as summary bills can obscure individual charges or unbundled codes. If you choose to use insurance, be aware that prompt-pay discounts of 20% to 50% may be available if you pay in full upfront, bypassing the administrative costs associated with claims processing. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should still confirm your deductible status and ask the facility about self-pay or prompt-pay rates prior to scheduling to avoid unexpected costs.