Ultrasound, thyroid and neck
Facility: Oakleaf Surgical Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $104
- Cash Discount Price: $288
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $104 - $389 | 97% |
| Dean Health Plan | $104 | 97% |
| Group Health Cooperative Of Eau Claire | $104 | 97% |
| Healthpartners | $104 | 97% |
| Humana | $104 | 97% |
| Medica | $104 | 97% |
| Quartz Health Solutions | $104 | 97% |
| Security Health Plan Of Wi | $104 - $876 | 97% |
| Ucare Wi | $104 | 97% |
| UnitedHealthcare | $104 | 97% |
Consumer Guidance & Cost Commentary
For this Ultrasound procedure for the thyroid and neck at Oakleaf Surgical Hospital, the cash median rate of $288 is significantly lower than the facility's gross charge of $320. While the data does not provide specific state or county average figures for comparison, the facility is a Physician-owned Acute Care Hospital located in Altoona, Wisconsin. The cash rate of $288 represents a substantial discount from the listed gross amount, illustrating that paying directly can often be more cost-effective than relying on standard billing cycles.
The negotiated rate for in-network payers averages $104, which is notably lower than the cash price of $288. This demonstrates that patients with high-deductible plans or those who have not met their out-of-pocket maximums may find the insurance negotiated rate of $104 to be the most economical option, even though it is lower than the cash-pay price. However, because the cash rate is higher than the negotiated rate, patients should verify their specific plan details and ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are selecting the most favorable payment method for their situation.