CT scan, sinuses
Facility: Stevens County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $670
- Cash Discount Price: $770
- vs. Medicare Baseline: 6.27x 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 627% of the Medicare baseline (a markup of 527%). 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 |
|---|---|---|
| Humana | $285 | 267% |
| Aetna | $293 - $770 | 274% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| First Health - All Plans | $693 | 649% |
| Wppa - All Plans | $732 | 685% |
| Medicaid / KanCare | $770 | 721% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Stevens County Hospital in Hugoton, Kansas, the cash price is $770.00, which matches the facility's gross chargemaster rate. While the hospital is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by insurer, ranging from $285 for Humana to $770 for Medicaid/KanCare. It is important to note that commercial insurance plans often pay negotiated rates that are higher than the cash price; for example, Aetna's negotiated range extends up to the full $770.00. Patients with high-deductible plans or those without insurance may find it financially advantageous to pay the cash price directly, as this avoids the administrative overhead and markup inherent in insurance billing cycles. Before scheduling, it is recommended to explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
The Medicare benchmark for this service is $106.81, providing a clear baseline for evaluating the facility's pricing structure. The cash price of $770.00 represents a significant markup compared to the Medicare rate, a common practice in the healthcare industry where commercial rates reflect provider costs plus administrative fees and profit margins. While the data does not include specific county or state average comparisons for this specific CPT code, the facility's ownership by the local government and its status as a Critical Access Hospital are key factors influencing these rates. To ensure you are not overcharged, patients should request a detailed, itemized bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled