CT scan, sinuses
Facility: Rawlins County Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,196
- Cash Discount Price: $1,169
- vs. Medicare Baseline: 11.20x 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 1120% of the Medicare baseline (a markup of 1020%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $458 | 429% |
| UnitedHealthcare | $1,196 | 1120% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Rawlins County Health Center in Atwood, Kansas, the cash price is $1,169, which is lower than the facility's negotiated rate of $1,196. This cash rate is also lower than the state average for this procedure. While the facility is a Critical Access Hospital owned by a voluntary non-profit, patients with high-deductible plans might find paying out-of-pocket cheaper than using insurance, as the negotiated rate often exceeds the cash price. However, patients should verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
It is important to understand that commercial insurance rates are often higher than cash prices due to administrative costs and contract structures. In this case, the Medicare benchmark for this service is $106.81, which serves as a baseline for fair pricing; commercial rates are typically marked up significantly above this figure. If you are billed more than the allowed amount by your insurance, you may be facing balance billing, which is generally prohibited for emergency care under the No Surprises Act. To avoid unexpected costs, always request an itemized bill before paying, ensuring you can identify any errors or unbundled charges that might be inflating your total.