CT scan, sinuses
Facility: Graham County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $492
- Cash Discount Price: $635
- vs. Medicare Baseline: 4.61x 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 461% of the Medicare baseline (a markup of 361%). 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 |
|---|---|---|
| UnitedHealthcare | $145 - $603 | 136% |
| Medicaid / KanCare | $145 | 136% |
| Blue Cross Blue Shield | $453 | 424% |
| Medicare (plans) | $476 | 446% |
| Celtic Commercial-All Other Plans | $524 | 491% |
| Wppa (Providers Care)-All Plans | $603 | 565% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Graham County Hospital in Hill City, Kansas, the cash price is $635.00, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. In this case, the highest negotiated rate is $603.00 (UnitedHealthcare), which is lower than the cash price, but other payers like Celtic Commercial and Wppa (Providers Care) have negotiated rates of $524.00 and $603.00 respectively. If you have a high-deductible plan, paying the cash price of $635.00 upfront might be more cost-effective than waiting for insurance to process a claim, especially if your deductible is high or if the insurer's allowed amount is close to the cash rate.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before paying any invoice, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, if you receive a balance bill for the difference between the provider's chargemaster and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services at in-network facilities. Before finalizing payment, contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can range from 20% to 50% for upfront payments, and verify that your specific plan has been correctly classified as in-network to avoid unexpected out-of-pocket costs