CT scan, sinuses
Facility: F W Huston Medical Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,069
- Cash Discount Price: $1,079
- vs. Medicare Baseline: 10.01x 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 1001% of the Medicare baseline (a markup of 901%). 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% |
| Aetna | $954 - $1,069 | 893% |
| Humana | $1,005 - $1,126 | 941% |
| Cigna | $1,081 - $1,211 | 1012% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at F W Huston Medical Center in Winchester, KS, the cash median price is $1,079, which is lower than the facility's negotiated rates of $1,069 to $1,211 across four payers including Aetna, Cigna, Humana, and Blue Cross Blue Shield. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should verify if their specific insurance plan has a deductible that would require them to pay the higher negotiated amount before coverage kicks in. It is important to note that cash-pay options can sometimes be more cost-effective for individuals with high-deductible plans if the insurance negotiated rate exceeds the cash price, so requesting a self-pay or prompt-pay discount before scheduling is recommended to avoid unexpected costs.
The Medicare benchmark for this procedure is $106.81, which serves as the objective baseline for evaluating pricing markups; commercial rates are often significantly higher due to administrative overhead and contract dynamics. Although the data does not provide specific county or state average comparisons for this code, the facility's location in Winchester (ZIP 66097) is relevant for understanding local cost structures. To ensure you are receiving fair pricing, patients should request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Disputing any discrepancies should be done in writing to the billing supervisor to protect your rights and prevent double-charging.