CT scan, sinuses
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $637
- Cash Discount Price: $466
- vs. Medicare Baseline: 5.96x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 596% of the Medicare baseline (a markup of 496%). 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 |
|---|---|---|
| Black Lung [6055] | $637 | 596% |
| Healthcare Highways [2210] | $637 | 596% |
| Hooray Health [8000] | $637 | 596% |
| Blue Cross Blue Shield | $637 | 596% |
| Oncology Patient Assistance Programs [2295] | $637 | 596% |
| Aetna | $637 | 596% |
| Lucent Health [6000] | $637 | 596% |
| Web Tpa [2115] | $637 | 596% |
| Department Of Corrections [1340] | $777 | 727% |
| Cigna | $898 | 841% |
| Healthpartners [1500] | $898 | 841% |
| American Postal Workers Union [1070] | $898 | 841% |
| National Association Of Letter Carriers [1695] | $898 | 841% |
| Humana | $917 | 859% |
| Administrative Concepts [1005] | $1,208 | 1131% |
| American Healthcare [1055] | $1,208 | 1131% |
| First Health [1375] | $1,208 | 1131% |
| Multiplan [1680] | $1,208 | 1131% |
| Coventry Healthcare [1320] | $1,274 | 1193% |
| Ks Disability Determination [6090] | $1,554 | 1455% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at the University of Kansas Health System - St Francis Campus in Topeka, the facility's negotiated rate is $637, which is significantly lower than the gross charge of $1,554. This negotiated amount aligns with the median paid across all 20 payers listed, including major carriers like Aetna, Cigna, and Humana. However, for patients with high-deductible plans, paying cash directly can be more cost-effective, as the cash price of $466 is substantially lower than the insurance negotiated rate. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as hospitals often offer immediate fee reductions for upfront payments that bypass the administrative costs associated with insurance claims processing.
It is important to note that the facility's cash price of $466 is also lower than the state of Kansas average for this procedure, making it a competitive option for self-pay patients. While the Medicare benchmark for this service is $106.81, commercial rates naturally exceed this baseline due to the inclusion of administrative overhead and network agreements. Patients should be aware that balance billing is generally prohibited for in-network services under federal law, but they must ensure they are not signing away rights to dispute out-of-network ancillary services. If a patient receives a bill exceeding the cash price, they should request a detailed itemized audit to verify that all charges correspond to services actually rendered and that no unbundled codes or errors have inflated the total.