CT scan, sinuses
Facility: Sheridan County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $662
- Cash Discount Price: $914
- vs. Medicare Baseline: 6.20x 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 620% of the Medicare baseline (a markup of 520%). 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 |
|---|---|---|
| Celtic Insurance | $553 | 518% |
| Blue Cross Blue Shield | $662 | 620% |
| UnitedHealthcare | $868 | 813% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Sheridan County Hospital in Hoxie, Kansas, the cash price is $914.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, reflecting the facility's status as a Critical Access Hospital owned by the local government. While commercial insurance carriers like Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare have negotiated rates ranging from $553 to $868, these amounts often exceed the cash price for patients with high-deductible plans. In such cases, paying the full cash price upfront can be more cost-effective than relying on insurance, as the negotiated rates include administrative overhead and do not reflect the actual cost of care.
Patients should be aware that commercial insurance rates are not always the lowest available option; in fact, they can sometimes be higher than self-pay rates due to the administrative costs of claims processing and contract management. To potentially lower your bill, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which may offer a reduction for upfront payment. Additionally, if you have received a bill from this facility, you should request a detailed, itemized statement to review every charge, as summary bills often obscure individual costs and may contain errors. Comparing your specific situation to the Medicare benchmark of $106.81 reveals that the facility's pricing structure is well above the federal baseline, highlighting the importance of verifying your plan's allowed amount before scheduling any services.