CT scan, sinuses
Facility: Saint Luke'S South Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,009
- Cash Discount Price: $2,701
- vs. Medicare Baseline: 9.45x 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 945% of the Medicare baseline (a markup of 845%). 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $136 | 56% |
| Humana | $95 - $156 | 89% |
| UnitedHealthcare | $114 - $1,009 | 107% |
| Cigna | $118 - $3,417 | 110% |
| Aetna | $121 - $4,277 | 113% |
| Transplants-Case Rates [5750] | $169 - $4,502 | 158% |
| Blue Cross Blue Shield | $252 - $3,381 | 236% |
| Commercial-Contracted [8000] | $959 - $3,642 | 898% |
| First Health [5512] | $2,669 | 2499% |
Consumer Guidance & Cost Commentary
Saint Luke's South Hospital in Overland Park, Kansas, reported a cash median rate of $2,701 for a CT scan of the sinuses, which is significantly lower than its gross charge of $4,502. While the facility's negotiated rates vary widely by insurer, ranging from $60 to $4,502, the median negotiated rate stands at $1,009 and the median paid amount is $282. This procedure is priced at 9.4 times the Medicare amount of $106.81, highlighting that commercial rates often exceed the federal benchmark. For patients with high-deductible plans, paying the cash price of $2,701 upfront may be more cost-effective than relying on insurance, as the median negotiated rate of $1,009 could result in higher out-of-pocket costs if the patient's deductible has not been met.
To minimize unexpected costs, patients should explicitly request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Even if a patient has insurance, they should verify their deductible status and ask for self-pay or prompt-pay discounts, which can reduce the bill by 20% to 50% for upfront payment. It is crucial to avoid accepting summary bills that obscure individual charges and instead demand a full CPT-coded statement to identify potential overcharges. By comparing the facility's rates to Medicare benchmarks and seeking formal written audit disputes for any errors, consumers can ensure they are not paying inflated charges based on the hospital's chargemaster list.