CT scan, sinuses
Facility: Mcpherson Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,213
- Cash Discount Price: $1,282
- vs. Medicare Baseline: 11.36x 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 1136% of the Medicare baseline (a markup of 1036%). 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 |
|---|---|---|
| UnitedHealthcare | $32 - $1,949 | 30% |
| Tricare | $33 - $85 | 31% |
| Humana | $38 - $96 | 36% |
| Wellcare Mcr Adv - All Plans | $38 - $96 | 36% |
| Blue Cross Blue Shield | $38 - $96 | 36% |
| Ambetter / Centene | $38 - $111 | 36% |
| Va Ccn - All Plans | $38 - $96 | 36% |
| Aetna | $38 - $1,949 | 36% |
| Healthy Blue Mcr Adv | $38 - $96 | 36% |
| Multiplan - All Plans | $47 - $1,754 | 44% |
| Medicaid / KanCare | $106 - $1,949 | 99% |
| Health Blue Mcaid - All Other Plans | $108 - $1,988 | 101% |
| Central Plains - All Plans | $264 - $1,462 | 247% |
| Medical Associates - All Plans | $264 - $1,462 | 247% |
| Health Partners - All Plans | $334 - $1,852 | 313% |
| Cigna | $334 - $1,852 | 313% |
| Wppa - All Plans | $1,213 - $1,364 | 1136% |
| Christian Health Aid - All Plans | $1,386 - $1,559 | 1298% |
| First Health - All Plans | $1,646 - $1,852 | 1541% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at McPherson Hospital in McPherson, Kansas, the facility's cash median price is $1,282, while the median negotiated rate across 19 payers is $1,375. This suggests that for patients with high-deductible plans or those without insurance, paying cash directly may be more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility is an in-network location for many plans, the actual amount paid by insurers varies significantly; for example, UnitedHealthcare plans range from $32 to $1,949, whereas Medicaid/KanCare plans range from $106 to $1,949. Patients should verify their specific plan's allowed amount before scheduling, as assuming that in-network status guarantees the lowest price can lead to unexpected costs if their deductible has not yet been met.
To ensure you are receiving the best possible rate, consider requesting a "prompt-pay" discount if you choose to pay out-of-pocket, as hospitals often offer reductions for upfront payments to bypass administrative billing cycles. Additionally, if you are billed by an insurance company, you should request an itemized billing audit to review every line item, as over 80% of hospital bills contain errors such as double-charging or unbundled codes that should be consolidated. While the facility's Medicare benchmark is $106.81, commercial rates are typically higher due to administrative overhead and contract dynamics; however, comparing your specific allowed amount to the Medicare rate can reveal if the negotiated fee is appropriately marked up. Finally, if you receive a balance bill for out-of-network