Ultrasound, thyroid and neck
Facility: Centura St. Catherine-Dodge City
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $893
- Cash Discount Price: $543
- vs. Medicare Baseline: 8.36x 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 836% of the Medicare baseline (a markup of 736%). 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 |
|---|---|---|
| Medicare (plans) | $72 | 67% |
| Humana | $72 | 67% |
| Kansas Health | $72 | 67% |
| Cigna | $72 | 67% |
| Kaiser | $72 | 67% |
| Blue Cross Blue Shield | $72 - $565 | 67% |
| Aetna | $72 - $1,086 | 67% |
| Centura Employee Plan | $205 | 192% |
| UnitedHealthcare | $893 | 836% |
| Wpaa | $950 | 889% |
| Christian Health Aid | $1,086 | 1017% |
| Multiplan | $1,086 - $1,222 | 1017% |
| Health Partners Of Kansas | $1,222 | 1144% |
Consumer Guidance & Cost Commentary
For this ultrasound of the thyroid and neck at Centura St. Catherine-Dodge City, the cash median price is $543.00, which is significantly lower than the facility's negotiated rates ranging from $72 to $1,222 depending on the insurance plan. While many commercial payers like Aetna and Multiplan have negotiated rates exceeding $1,000, the cash price remains the most transparent baseline for patients. It is important to note that while cash payment can sometimes be cheaper for those with high-deductible plans, patients should always verify their specific deductible status before assuming insurance will result in higher out-of-pocket costs. Additionally, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if paid in full upfront.
The facility's pricing structure is evaluated against federal benchmarks, where the Medicare amount of $106.81 serves as the objective baseline for cost transparency. Commercial negotiated rates often average 200% to 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this rate. In this case, the median negotiated rate of $893.00 reflects the contractual agreements between the hospital and various insurers, which include administrative overhead and claim processing costs. Patients should be aware that summary bills may obscure individual charges, so requesting a detailed, itemized statement is crucial for identifying any errors, unbundled codes, or services not rendered before finalizing payment.