CT scan, sinuses
Facility: Hamilton County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,075
- Cash Discount Price: $1,175
- vs. Medicare Baseline: 10.06x 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 1006% of the Medicare baseline (a markup of 906%). 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 | $215 - $480 | 201% |
| First Health Coventry - All Plans | $914 - $1,084 | 856% |
| UnitedHealthcare | $1,021 - $1,211 | 956% |
| Cigna | $1,021 - $1,211 | 956% |
| Va Ccn - All Plans | $1,075 - $1,275 | 1006% |
| Aetna | $1,828 - $2,168 | 1711% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Hamilton County Hospital in Syracuse, KS, the cash price is $1,175, which matches the facility's median negotiated rate. This cash price is significantly higher than the state average, as indicated by the 10.1% variance compared to Medicare benchmarks. While commercial insurance plans like Blue Cross Blue Shield and First Health Coventry negotiate rates ranging from $215 to $1,275, these amounts often exceed the cash price for patients with high-deductible plans. Because commercial negotiated rates can include administrative overhead and contract markups, paying cash upfront may result in lower out-of-pocket costs than relying on insurance reimbursement, provided you have not yet met your deductible.
Patients should verify their specific plan details before scheduling, as assuming that being in-network guarantees the lowest price is a common pitfall. Although the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to request a self-pay or prompt-pay discount prior to check-in to avoid unexpected charges. Hamilton County Hospital, a government-owned Critical Access Hospital, offers a median negotiated rate of $1,075, which remains above the Medicare amount of $106.81. To ensure you are receiving the most accurate pricing, always ask for an itemized bill that breaks down each CPT code, as summary bills can obscure individual charges and potential errors.