CT scan, sinuses
Facility: Stafford County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $766
- Cash Discount Price: $766
- vs. Medicare Baseline: 7.17x 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 717% of the Medicare baseline (a markup of 617%). 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 |
|---|---|---|
| Health Partners-All Plans | $728 | 682% |
| UnitedHealthcare | $766 | 717% |
| Va Ccn-All Plans | $766 | 717% |
| Humana | $766 | 717% |
| Medica Mcr- All Plans | $766 | 717% |
Consumer Guidance & Cost Commentary
For the CPT code 70486 (CT scan, sinuses) at Stafford County Hospital in Stafford, KS, the cash median price is $766.00, which matches the facility's negotiated rates across all five major payers including UnitedHealthcare, Humana, and Health Partners-All Plans. This indicates that for this specific service, there is no financial advantage to paying out-of-network or using a commercial plan, as the commercial negotiated rate is identical to the cash price. Unlike many facilities where cash-pay offers significant savings over insurance billing, this service is priced consistently at $766.00 regardless of payment method, meaning patients with high-deductible plans will not save money by paying cash directly.
The facility's pricing for this procedure is notably higher than the Medicare benchmark, which is set at $106.81, reflecting a markup typical of commercial healthcare pricing. While the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, it is important to note that this rate represents the final contracted amount rather than a discounted cash price. Patients should be aware that while prompt-pay discounts are common for self-pay services, they are not applicable here since the cash rate is already equal to the negotiated rate. To ensure you are receiving the most accurate billing information, we recommend requesting a full itemized bill to verify that no unbundled codes or services not rendered have been included in the final charge.