CT scan, sinuses
Facility: Providence Medical Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $133
- Cash Discount Price: $98
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Medicaid / KanCare | $60 | 56% |
| UnitedHealthcare | $91 - $202 | 85% |
| Healthy Blue | $93 - $103 | 87% |
| Celtic | $93 - $158 | 87% |
| Cigna | $98 | 92% |
| Midland Care Connection | $98 | 92% |
| Medicare (plans) | $98 | 92% |
| Aetna | $98 - $271 | 92% |
| Tricare | $98 | 92% |
| Kansas Superior Select | $103 | 96% |
| Corizon | $128 | 120% |
| Employer Direct Healthcare | $138 | 129% |
| Well Path Prison | $138 | 129% |
| Comp Alliance - Fka Compresults Worker Compensation | $142 | 133% |
| Centurion | $148 | 139% |
| Naphcare | $153 | 143% |
| Oha Networks | $153 | 143% |
| Worker Compensation | $157 | 147% |
| Blue Cross Blue Shield | $158 - $255 | 148% |
| First Health | $750 | 702% |
Consumer Guidance & Cost Commentary
For patients at Providence Medical Center in Kansas City, KS, the cash price for a CT scan of the sinuses (CPT 70486) is $98.00, which is significantly lower than the facility's gross charge of $5,119.00. While commercial insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $91 to $271, the cash rate remains the lowest option available. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective than using insurance, especially for patients with high deductibles or those who may face balance billing if their specific plan does not cover the service. The facility's cash rate of $98.00 is notably lower than the state average for this procedure, offering a clear financial advantage for self-pay patients who can secure the service directly.
To minimize unexpected costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can further reduce the final bill. It is also critical to avoid accepting summary bills that obscure individual charges; instead, patients should demand a full itemized audit to verify that no unbundled codes or services not rendered are included in the total. Since over 80% of hospital bills contain errors, reviewing the line-by-line statement is the most effective way to identify and dispute inaccuracies. Finally, while Medicare serves as a reliable benchmark for pricing fairness, patients should compare their negotiated or cash rates against this federal standard rather than the inflated chargemaster list to understand the true cost of care.