CT scan, sinuses
Facility: Wichita County Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,144
- Cash Discount Price: $1,003
- vs. Medicare Baseline: 10.71x 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 1071% of the Medicare baseline (a markup of 971%). 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 | $1,035 | 969% |
| UnitedHealthcare | $1,254 | 1174% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Wichita County Health Center, the cash price of $1,003 is notably lower than the facility's gross charge of $1,254, offering a potential savings for patients without insurance. This cash rate also compares favorably to the state of Kansas average, which stands at $1,003, meaning paying out-of-pocket aligns exactly with the statewide median. While the facility is a Critical Access Hospital with government local ownership, the $1,003 cash price remains competitive relative to the broader state landscape for this procedure.
Insurance coverage for this service varies significantly by payer, with Medicaid/KanCare and UnitedHealthcare both reporting a single rate of $1,035 and $1,254 respectively. It is important to note that while the negotiated rates for these payers are higher than the cash price, patients with high-deductible plans might find the cash price more beneficial if the insurance allowed amount exceeds the $1,003 cash rate. To secure the lowest possible cost, consumers should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can reduce the final bill further. Additionally, because over 80% of hospital bills contain errors, patients should always request an itemized billing audit to verify that no unbundled codes or services not rendered are included in the final invoice.