CT scan, sinuses
Facility: Stormont Vail Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- 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 |
|---|---|---|
| Ambetter / Centene | $61 - $93 | 57% |
| UnitedHealthcare | $61 - $93 | 57% |
| Blue Cross Blue Shield | $62 - $613 | 58% |
| Aetna | $96 - $98 | 90% |
| Humana | $96 - $98 | 90% |
Consumer Guidance & Cost Commentary
Stormont Vail Hospital in Topeka, KS, performed a CT scan of the sinuses (CPT 70486) with a gross charge of $2,041 and a Medicare benchmark rate of $106.81. The facility's cash median rate is not available in the current data, and the state or county average is not provided for comparison. For patients with high-deductible plans, the cash price could be more affordable than the insurance negotiated rates, which range from $61 to $98 depending on the payer. Since the cash price is not listed, patients should verify if the hospital offers a "self-pay" or "prompt-pay" discount to secure immediate liquidity benefits and avoid administrative fees associated with insurance billing cycles.
Commercial insurance contracts for this procedure show significant variation across payers, with Blue Cross Blue Shield having the highest negotiated rate range of $62 to $613, while Aetna and Humana range from $96 to $98. These negotiated amounts often exceed cash prices due to the administrative load and contractual ceilings inherent in insurance networks. To ensure fair pricing, consumers should request an itemized billing audit to verify that no unbundled codes or services not rendered are included in the final statement, as over 80% of hospital bills contain errors. Always confirm your deductible status before scheduling to avoid unexpected costs, and remember that the No Surprises Act protects against balance billing for out-of-network services at this in-network facility.