CT scan, sinuses
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $96
- Cash Discount Price: $1,041
- vs. Medicare Baseline: 0.90x 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 |
|---|---|---|
| Humana | $94 | 88% |
| Providrs Care Network | $96 | 90% |
| Aetna | $96 - $120 | 90% |
| UnitedHealthcare | $96 - $116 | 90% |
| Blue Cross Blue Shield | $96 - $462 | 90% |
| United Mine Workers Of America | $96 | 90% |
| Lantern Specialty Care | $153 | 143% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Kansas Spine & Specialty Hospital, Llc in Wichita, KS, the cash median price is $1,041.00, which is significantly lower than the facility's gross charge of $1,602.00. While the facility's negotiated rates with major payers like Aetna and UnitedHealthcare range from $96 to $120, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket and seeking prompt-pay discounts before scheduling. It is important to note that while the facility is an Acute Care Hospital, the specific procedure listed is a CPT code for imaging; patients should verify their specific plan details and ask the hospital directly about self-pay or prompt-pay discounts to ensure they are receiving the most favorable rate available.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $106.81, and the facility's negotiated rate of $96.00 is actually below the Medicare benchmark, suggesting a highly competitive pricing structure that aligns with fair value standards. Although the data does not provide specific county or state average comparisons for this exact procedure, the significant gap between the gross charge and the negotiated or cash rates highlights the importance of understanding how insurance contracts and cash-pay options can drastically reduce out-of-pocket costs. Consumers should avoid accepting summary bills and instead request a detailed, itemized statement to confirm that no unbundled charges or services not rendered are included in the final invoice.