CT scan, sinuses
Facility: Ellinwood District Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $413
- Cash Discount Price: $502
- vs. Medicare Baseline: 3.87x 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 387% of the Medicare baseline (a markup of 287%). 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 |
|---|---|---|
| Cigna | $413 | 387% |
| Humana | $413 | 387% |
| UnitedHealthcare | $413 | 387% |
| Blue Cross Blue Shield | $413 | 387% |
| Aetna | $413 | 387% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Ellinwood District Hospital in Ellinwood, KS, the cash median price is $502.00, while the negotiated rate paid by major insurers like Cigna, Humana, and UnitedHealthcare is $413.00. In this specific case, paying out-of-pocket directly is more expensive than the insurer's negotiated rate, which is a common scenario where commercial contracts cap the price lower than the cash price. However, patients with high-deductible plans should verify their deductible status before scheduling, as paying the full $502.00 cash might still be cheaper than the $413.00 allowed amount if their insurance has not yet met their annual deductible threshold.
The facility's negotiated rate of $413.00 is 3.9% higher than the Medicare benchmark of $106.81, reflecting the standard markup found in commercial healthcare pricing. While the hospital is a Critical Access Hospital owned by a government district, patients should request an itemized bill before paying to ensure no errors, unbundled codes, or services not rendered are included in the total. If you receive a summary bill, ask for a detailed CPT-coded statement to identify any discrepancies, and always inquire about prompt-pay discounts before check-in, as paying upfront can sometimes reduce the final amount owed.