Ultrasound, thyroid and neck
Facility: Stormont Vail Hospital
Billing Code: 76536 (CPT)
- CPT Billing Code: 76536
- Insurance Median: $96
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.90x 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 | $61 - $93 | 57% |
| Ambetter / Centene | $61 - $93 | 57% |
| Blue Cross Blue Shield | $62 - $741 | 58% |
| Aetna | $96 - $98 | 90% |
| Humana | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
For the CPT code 76536, "Ultrasound, thyroid and neck," Stormont Vail Hospital in Topeka, KS, has a gross charge of $781.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range between $61 and $98, the median amount paid by insurers is significantly higher at $46,215.00, which is 0.9 times the Medicare benchmark of $106.81. This substantial difference between the negotiated rate and the actual payment suggests that commercial insurance contracts often include administrative markups or specific plan structures that result in higher out-of-pocket costs for members compared to the facility's cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the negotiated rate exceeds the cash price, potentially avoiding the full impact of their deductible.
To minimize unexpected costs, consumers should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payments can bypass the complex insurance billing cycle and administrative fees. It is also important to request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can inflate the total. If a balance bill arises from an out-of-network service, patients should not pay immediately out of fear of credit damage but instead dispute the charge with their insurer to request a No Surprises Act audit. Finally, comparing the facility's rates to state or county averages provides context, though the data provided does not include specific average figures for Topeka or