CT scan, sinuses
Facility: Kiowa County Memorial Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $712
- Cash Discount Price: $680
- vs. Medicare Baseline: 6.67x 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 667% of the Medicare baseline (a markup of 567%). 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 | $458 - $712 | 429% |
| UnitedHealthcare | $641 - $800 | 600% |
| Health Partners Of Ks-All Plans | $704 | 659% |
| Aetna | $712 | 667% |
| Celtic Comml Exchange-All Other Plans | $712 | 667% |
| Humana | $712 | 667% |
| Medica Prime Mcare Cost-All Plans | $712 | 667% |
| Medicaid / KanCare | $800 | 749% |
| Providrs Care/Wppa-All Plans | $1,200 | 1123% |
Consumer Guidance & Cost Commentary
Kiowa County Memorial Hospital in Greensburg, Kansas, offers a CT scan of the sinuses with a cash median price of $680. This cash rate is notably lower than the facility's gross charge of $800, reflecting the standard discount available for self-pay patients. For those with high-deductible plans, paying the cash price of $680 could be more cost-effective than the negotiated rates, which range from $458 to $1,200 depending on the insurance carrier. Patients should contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling the procedure.
While the facility's gross charge of $800 serves as the maximum list price, commercial insurance negotiated rates cap the cost significantly lower, with most payers settling at $704 to $712. However, specific plans like Medicaid/KanCare and certain commercial carriers may result in higher allowed amounts of $800 or $1,200. To ensure accuracy, consumers should request an itemized billing audit to verify that no unbundled codes or services not rendered have inflated the final statement. Additionally, if a balance bill arises from an out-of-network ancillary service, the No Surprises Act may provide protection against unexpected charges, allowing patients to dispute the bill formally rather than accepting it immediately.