CT scan, sinuses
Facility: Kansas Heart Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,665
- Cash Discount Price: $1,166
- vs. Medicare Baseline: 15.59x 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 1559% of the Medicare baseline (a markup of 1459%). 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 |
|---|---|---|
| Tricare | $87 | 81% |
| Humana | $96 | 90% |
| Medicaid / KanCare | $96 - $1,850 | 90% |
| Celtic Mcr Adv | $96 | 90% |
| UnitedHealthcare | $96 - $1,850 | 90% |
| Blue Cross Blue Shield | $462 - $1,850 | 433% |
| Wppa - All Plans | $541 | 507% |
| Multiplan - All Plans | $1,665 | 1559% |
| Aetna | $1,804 - $1,850 | 1689% |
| Celtic Mcaid - All Other Plans | $1,850 | 1732% |
| Soonerselect Mcaid - All Plans | $1,850 | 1732% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Kansas Heart Hospital in Wichita, the cash price is $1,166, which is lower than the facility's negotiated rates for most major payers. While the facility's cash rate is significantly below the gross charge of $1,850, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash price. It is important to note that while the facility's cash rate is competitive, the state and county averages for this procedure are not provided in this report, so patients should verify local pricing trends before scheduling.
The facility's negotiated rates vary widely depending on the insurance carrier, ranging from $87 for Tricare to $1,850 for certain Medicaid plans, with a median negotiated amount of $1,665. This variation highlights the impact of network tiering and contract dynamics, where some insurers pay significantly less than the gross charge while others match it entirely. Patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, but unexpected charges can still occur if ancillary services are out-of-network. To minimize costs, patients should request a prompt-pay discount or self-pay rate before check-in and always demand a full itemized bill to review for errors or unbundled codes before making any payment.