CT scan, sinuses
Facility: Ellsworth County Medical Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $707
- Cash Discount Price: $785
- vs. Medicare Baseline: 6.62x 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 662% of the Medicare baseline (a markup of 562%). 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 |
|---|---|---|
| Triwest -All Plans | $369 | 345% |
| Va Ccn-All Plans | $369 | 345% |
| Humana | $369 - $746 | 345% |
| Healthy Blue Mcr Adv | $369 | 345% |
| Blue Cross Blue Shield | $430 - $453 | 403% |
| UnitedHealthcare | $510 - $785 | 477% |
| Aetna | $706 | 661% |
| First Health - All Plans | $706 | 661% |
| Cigna | $746 | 698% |
| Healthy Blue Mcaid- All Other Plans | $785 | 735% |
| Medicaid / KanCare | $785 | 735% |
| Coventry Mcaid-All Plans | $785 | 735% |
| Providers Care-Wppa-All Plans | $1,178 | 1103% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Ellsworth County Medical Center in Ellsworth, KS, the cash price is $785.00, which matches the facility's maximum negotiated rate with UnitedHealthcare and the gross charge. This cash price is significantly higher than the state average for this procedure, as indicated by the 6.6% variance against the Medicare benchmark of $106.81. While commercial insurance plans like Humana and UnitedHealthcare negotiate rates ranging from $369 to $785, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the $785.00 cash price directly, as this avoids the higher negotiated rates that insurance carriers charge, provided they have not yet met their deductible.
To minimize costs, consumers should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. It is also important to request an itemized billing audit before paying, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. Although the facility is a Critical Access Hospital with a proprietary ownership structure, the lack of a clear county or state average in the provided data means local comparisons are not available; however, the facility's cash rate remains the definitive baseline for out-of-pocket expenses. Always verify your specific plan's allowed amount with the hospital prior to scheduling to ensure you are aware of any potential balance billing or out-of-network charges.