CT scan, sinuses
Facility: Kansas City Orthopaedic Institute
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $254
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.38x 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 238% of the Medicare baseline (a markup of 138%). 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 |
|---|---|---|
| UnitedHealthcare | $98 | 92% |
| Aetna | $98 | 92% |
| Cigna | $100 | 94% |
| Blue Cross Blue Shield | $254 | 238% |
Consumer Guidance & Cost Commentary
For the CT scan of the sinuses at Kansas City Orthopaedic Institute in Leawood, KS, the negotiated rate is $254.00, which is significantly higher than the state average of $106.81. While this facility is in-network for UnitedHealthcare, Aetna, Cigna, and Blue Cross Blue Shield, patients with high-deductible plans might find paying the cash price more beneficial if the insurance negotiated rate exceeds the cash amount. Although cash rates are not listed in this report, it is standard practice to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
Because commercial insurance rates often include administrative overhead and contract markups, they can sometimes be higher than the Medicare benchmark of $106.81 or the facility's own cash pricing. The No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, but patients should still verify their deductible status before scheduling to avoid unexpected out-of-pocket costs. If you receive a summary bill, always request a full itemized statement to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.