CT scan, sinuses
Facility: Saint John Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $103
- Cash Discount Price: $98
- vs. Medicare Baseline: 0.96x 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $91 - $138 | 85% |
| Celtic | $93 - $158 | 87% |
| Healthy Blue | $93 - $103 | 87% |
| Medicare (plans) | $98 | 92% |
| Cigna | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Aetna | $98 - $222 | 92% |
| Tricare | $98 | 92% |
| Kansas Superior Select | $100 | 94% |
| Well Path | $138 | 129% |
| Corizon | $138 | 129% |
| Employer Direct Healthcare | $138 | 129% |
| Comp Alliance Workers Comp | $142 | 133% |
| Centurion | $148 | 139% |
| Naphcare | $153 | 143% |
| Oha Networks | $153 | 143% |
| Worker Compensation | $157 | 147% |
| Blue Cross Blue Shield | $228 - $480 | 213% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Saint John Hospital in Leavenworth, KS, the cash median price is $98.00, which is significantly lower than the negotiated rates charged by most insurance payers. While the facility's cash rate is also lower than the state average for this procedure, patients should be aware that commercial insurance plans often negotiate rates that exceed the cash price due to administrative costs and contract structures. For individuals with high-deductible plans, paying the cash price upfront can sometimes result in lower out-of-pocket costs compared to the insurance allowed amount, provided the patient qualifies for a self-pay or prompt-pay discount. It is advisable to contact the hospital directly before scheduling to confirm if they offer a prompt-pay discount for upfront payment, which can bypass the higher negotiated rates and reduce administrative fees.
The Medicare benchmark for this service is $106.81, which serves as a reliable baseline for evaluating the facility's pricing markup. Commercial negotiated rates for this procedure range widely across different insurers, with the lowest allowed amount being $60 and the highest reaching $480, indicating significant variation in how payers contract with the hospital. Because the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, patients should not immediately pay surprise bills without first disputing them with their insurer or requesting a formal audit. If a patient receives an itemized bill, they should request a line-by-line review to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain discrepancies that can be corrected through a written dispute sent to the billing supervisor.