CT scan, sinuses
Facility: Stanton County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,587
- Cash Discount Price: $1,670
- vs. Medicare Baseline: 14.86x 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 1486% of the Medicare baseline (a markup of 1386%). 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 | $456 - $1,587 | 427% |
| Healthy Blue Mcr Adv - All Other Plans | $1,636 | 1532% |
| Healthy Blue Mcaid | $1,670 | 1564% |
Consumer Guidance & Cost Commentary
For the CPT code 70486 representing a CT scan of the sinuses at Stanton County Hospital in Johnson, KS, the cash price is $1,670.00, which matches the facility's negotiated rate with Healthy Blue Mcaid and the high-end of the range for Blue Cross Blue Shield. This cash price is significantly higher than the state average for this procedure, as indicated by a 14.9% variance compared to the Medicare benchmark of $106.81. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that paying cash upfront may still be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price, though in this specific case, the cash rate aligns with the highest negotiated figures available.
To minimize potential costs, patients should actively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing administrative processing fees and collection costs. It is crucial to avoid accepting summary bills that obscure individual charges; instead, demand a full itemized statement to verify that no unbundled codes or services not rendered are included. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still review their specific plan details to ensure they are not inadvertently triggering unexpected costs through ancillary services or deductible requirements.