CT scan, sinuses
Facility: Kansas Surgery & Recovery Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $207
- Cash Discount Price: $782
- vs. Medicare Baseline: 1.94x 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 |
|---|---|---|
| Blue Cross Blue Shield | $96 - $458 | 90% |
| Aetna | $96 - $389 | 90% |
| UnitedHealthcare | $98 - $534 | 92% |
| Cigna | $251 | 235% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Kansas Surgery & Recovery Center in Wichita, KS, the cash price is $782.00, which is significantly lower than the facility's gross charge of $786.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Aetna range from $96 to $534, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the insurer's allowed amount could exceed the cash rate. It is important to note that the cash median of $782.00 is close to the gross charge, suggesting limited room for discount negotiation on the list price itself.
To minimize potential costs, patients should actively request a "prompt-pay" discount or self-pay rate before scheduling, as hospitals often offer 20% to 50% reductions for upfront payment to bypass insurance billing cycles. Additionally, if you are covered by insurance, you should verify your deductible status, as paying the negotiated rate before meeting your deductible could result in out-of-pocket expenses that exceed the cash price. While this specific procedure does not include a state or county average for comparison in the provided data, understanding that commercial negotiated rates frequently include a markup over the Medicare benchmark of $106.81 helps clarify why insurance payments might appear higher than cash options. Always ask for an itemized bill to ensure no errors exist before finalizing payment.