CT scan, sinuses
Facility: Logan County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,031
- Cash Discount Price: $375
- vs. Medicare Baseline: 9.65x 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 965% of the Medicare baseline (a markup of 865%). 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% |
| Humana | $636 | 595% |
| Health Partners - All Plans | $1,425 | 1334% |
| Medicaid / KanCare | $1,500 | 1404% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Logan County Hospital in Oakley, Kansas, the facility's cash median rate is $375, which is significantly lower than the state average of $1,031. While the hospital is a Critical Access Hospital owned by the local government, patients should note that commercial insurance negotiated rates often exceed cash prices due to administrative overhead. Specifically, the negotiated rate for this service is $1,031, which is higher than the cash price; however, this rate may still be the most cost-effective option if your insurance plan has a high deductible or if you have not yet met your out-of-pocket threshold. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated amount upfront could result in a higher total cost than paying the cash price directly.
When comparing this service to Medicare, the facility's allowed amount is $106.81, which serves as a scientifically validated baseline for evaluating pricing markups. The commercial negotiated rate of $1,031 represents a substantial markup relative to this federal benchmark, illustrating how commercial contracts can differ significantly from the true cost of care. Additionally, while Blue Cross Blue Shield, Humana, and Health Partners have specific negotiated rates of $480, $636, and $1,425 respectively, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts before check-in. These discounts, which can range from 20% to 50%, are designed to reduce costs for those paying in full and bypassing the insurance billing cycle, potentially lowering the final bill below the standard negotiated amounts.