CT scan, sinuses
Facility: Rooks County Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,461
- Cash Discount Price: $1,217
- vs. Medicare Baseline: 13.68x 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 1368% of the Medicare baseline (a markup of 1268%). 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 | $480 | 449% |
| Tricare | $763 | 714% |
| Celtic Mcr Adv | $763 | 714% |
| Veterans Admin - All Plans | $763 | 714% |
| Celtic Comm - All Other Plans | $839 | 786% |
| UnitedHealthcare | $1,461 | 1368% |
| Aetna | $1,461 | 1368% |
| Preferred Benefits Admin | $1,461 | 1368% |
| Preferred Hlthcare - All Other Plans | $1,542 | 1444% |
| Health Partners - All Plans | $1,542 | 1444% |
| Healthy Blue Mcaid - All Plans | $1,623 | 1520% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Rooks County Health Center in Plainville, Kansas, the facility's cash price of $1,217 is lower than the average negotiated rate of $1,461 paid by most major insurers, including UnitedHealthcare, Aetna, and Preferred Benefits Admin. While the facility is a Critical Access Hospital owned by a government authority, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, as the commercial negotiated rates often exceed the cash price. It is important to note that while the facility offers a cash rate, commercial payers have their own contracted ceilings that can be higher than the direct cash price, so verifying your specific plan's allowed amount before scheduling is essential to avoid unexpected costs.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing fairness; commercial rates are typically marked up significantly above this federal rate. Although the data does not provide specific county or state average comparisons for this procedure, the facility's cash price remains a critical reference point for consumers. If you receive a bill from an out-of-network provider or encounter unexpected charges, you have the right to request an itemized audit to identify errors such as unbundled codes or services not rendered, and you may be protected from balance billing for emergency care under the No Surprises Act. Always ask the billing department about prompt-pay discounts before check-in, as paying in full upfront can often reduce the total amount owed.