CT scan, sinuses
Facility: Wesley Medical Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $2,009
- Cash Discount Price: $11,615
- vs. Medicare Baseline: 18.81x 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 1881% of the Medicare baseline (a markup of 1781%). 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 | $60 | 56% |
| Amerigroup | $62 | 58% |
| Aetna | $62 - $4,147 | 58% |
| Medicaid / KanCare | $62 | 58% |
| First Health | $149 - $5,355 | 140% |
| Multiplan | $156 - $10,454 | 146% |
| United | $245 - $5,227 | 229% |
| Blue Cross Blue Shield | $478 | 448% |
| Health Partners Of Kansas | $2,009 - $5,808 | 1881% |
| Wppa | $2,021 | 1892% |
| Ambetter / Centene | $2,091 | 1958% |
| Preferred Health Choices | $2,195 | 2055% |
| Medical Associates Health Plan | $2,195 | 2055% |
| Spirit Aerosystems | $3,717 | 3480% |
| Triwest Healthcare Alliance | $7,550 | 7069% |
| Usa Managed Care | $9,873 | 9244% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Wesley Medical Center in Wichita, KS, the cash price is $11,615, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average for this procedure, indicating that paying out-of-pocket here would likely result in a higher cost than the typical patient in Kansas. While commercial insurance plans like Amerigroup and UnitedHealthcare have negotiated rates starting at $60, these figures represent the maximum allowed amount per plan rather than a single uniform price, and many plans may still require you to meet your deductible before coverage applies. Because commercial negotiated rates often include administrative overhead and can exceed the cash price for high-deductible plans, it is advisable to contact the hospital directly to confirm if a self-pay or prompt-pay discount is available before scheduling your visit.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing fairness. The facility's cash rate of $11,615 is 18.8 times higher than the Medicare amount, reflecting a substantial markup common in commercial billing structures. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it does not apply to self-pay scenarios or services rendered by out-of-network ancillary providers. To ensure you receive the most accurate and transparent pricing, request a full itemized bill listing every CPT code and unit cost before agreeing to payment terms, as summary bills often obscure individual charges. Additionally, verify your specific plan's allowed amount, as some insurers may have different caps than the facility's published range, and always ask about prompt-pay discounts to potentially reduce