CT scan, sinuses
Facility: Lmh
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $105
- Cash Discount Price: $155
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Humana | $39 - $105 | 37% |
| UnitedHealthcare | $39 - $412 | 37% |
| Medicare (plans) | $39 - $105 | 37% |
| Cigna | $39 - $414 | 37% |
| Blue Cross Blue Shield | $46 - $620 | 43% |
| Haskell Indian Health Services | $46 - $105 | 43% |
| Ambetter / Centene | $47 - $163 | 44% |
| Allwell | $47 - $107 | 44% |
| Non Contracted | $496 | 464% |
| Aetna | $514 - $620 | 481% |
| First Health | $576 | 539% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Lmh in Lawrence, KS, the facility's cash median price is $155.00, which is significantly lower than the gross charge of $620.00. While the facility is government-owned and located in Lawrence (ZIP 66044), the data does not provide specific county or state average figures for this procedure to compare against. However, the cash rate is notably lower than the negotiated rates paid by most major insurers, including UnitedHealthcare, Cigna, and Blue Cross Blue Shield, which range from $46 to $620 depending on the plan. For patients with high-deductible plans or those without insurance, paying the cash price directly may result in substantial savings compared to the allowed amounts billed by commercial payers.
Patients should be aware that while the No Surprises Act protects against balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, it is crucial to verify network status before scheduling. The data shows one non-contracted payer with a fixed rate of $496.00, which exceeds the cash price. To minimize costs, patients are encouraged to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if a patient receives an itemized bill, they should request a full line-by-line audit to ensure no unbundled codes or services not rendered have inflated the total, as over 80% of hospital bills contain errors.