CT scan, sinuses
Facility: St. Catherine Hospital - Garden City
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $383
- Cash Discount Price: $1,515
- vs. Medicare Baseline: 3.59x 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 359% of the Medicare baseline (a markup of 259%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $77 - $569 | 72% |
| Cigna | $77 - $310 | 72% |
| Aetna | $77 - $2,050 | 72% |
| Kaiser | $77 - $1,416 | 72% |
| Humana | $77 - $90 | 72% |
| UnitedHealthcare | $77 - $1,508 | 72% |
| Medicare (plans) | $77 - $90 | 72% |
| Kansas Health | $77 | 72% |
| Devoted Health | $90 | 84% |
| Innovage | $90 | 84% |
| United Colorado Doctor'S Plan | $245 | 229% |
| Direct To Employer | $322 - $2,056 | 301% |
| Centura Employee Plan | $337 | 316% |
| Peak Health | $433 - $2,004 | 405% |
| Multiplan | $592 - $4,368 | 554% |
| Denver Health | $1,213 | 1136% |
| Wpaa | $1,705 | 1596% |
| Christian Health Aid | $1,948 | 1824% |
| Health Partners Of Kansas | $2,362 | 2211% |
Consumer Guidance & Cost Commentary
A self-pay patient should know that paying cash directly for a CT scan of the sinuses at St. Catherine Hospital in Garden City, Kansas, can result in a significantly lower cost than what most insurance plans will allow. The facility's cash median rate is $1,515, which is notably lower than the median negotiated rate of $383 and the median paid amount of $112 reported for this service. While the cash price appears higher than the negotiated figures in this dataset, it is important to note that commercial insurance rates often include substantial administrative overhead and contractual markups, meaning the cash price can sometimes be more favorable for patients with high-deductible plans who have not yet met their out-of-pocket maximum. Patients are encouraged to verify "self-pay" or "prompt-pay" discounts with the hospital before scheduling to ensure they are receiving the lowest possible upfront rate.
The broader pricing context for this procedure reveals a wide variance in what different payers are willing to pay, ranging from a low of $77 for some plans to a high of $4,368 for Multiplan. The Medicare benchmark for this service is $106.81, which serves as a critical baseline for evaluating the facility's pricing markup; commercial rates often exceed this federal baseline by a significant margin. For instance, the gross chargemaster rate listed is $3,787, while the Medicare amount is only $106.81, highlighting the difference between the facility's full list price and the government's cost-based reimbursement. Although the data does not provide specific county or state average comparisons for this exact CPT code, understanding that Medicare represents the "true cost" of delivery helps patients recognize