Ultrasound, thyroid and neck
Facility: Susan B Allen Memorial Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $554
- Cash Discount Price: $450
- vs. Medicare Baseline: 5.19x 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 519% of the Medicare baseline (a markup of 419%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 328% |
| Providrs Care | $757 | 709% |
Consumer Guidance & Cost Commentary
For the ultrasound procedure covering the thyroid and neck at Susan B Allen Memorial Hospital in El Dorado, KS, the cash median price is $450.00, which is notably lower than the facility's gross charge of $693.00. This cash rate is significantly below the state average, offering a potential savings opportunity for patients with high-deductible plans or those without insurance. While the hospital's negotiated rates with UnitedHealthcare and Providrs Care are set at $350 and $757 respectively, the cash price may be more advantageous if your insurance allows a higher amount than $450.00. To maximize savings, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost before any insurance claim is processed.
It is important to understand that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures, meaning your out-of-pocket cost depends heavily on your specific plan's deductible and allowed amount. If you are billed for the difference between the provider's full charge and your insurance payment, this is known as balance billing, though federal protections like the No Surprises Act may limit these charges for emergency or non-emergency services at in-network facilities. Regardless of your coverage, we strongly advise requesting a full itemized bill to review every CPT code and unit cost, as over 80% of hospital bills contain errors such as unbundled services or charges for items not rendered. By disputing any inaccuracies in writing and comparing the final allowed amount to the Medicare benchmark of $106.81, you can ensure you are paying a fair price for this essential diagnostic service.