CT scan, sinuses
Facility: Cloud County Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $2,567
- Cash Discount Price: $1,892
- vs. Medicare Baseline: 24.03x 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 2403% of the Medicare baseline (a markup of 2303%). 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 |
|---|---|---|
| Aetna | $2,432 - $2,513 | 2277% |
| Mpi-All Plans | $2,567 | 2403% |
| Health Partners - All Plans | $2,567 | 2403% |
| Pponext-All Plans | $2,567 | 2403% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Cloud County Health Center in Concordia, KS, the facility's negotiated rate of $2,567 is consistent across all four commercial payers, including Aetna, Mpi-All Plans, and Health Partners - All Plans. This negotiated amount aligns with the median paid and median negotiated figures reported for this service. When compared to the Medicare benchmark of $106.81, the commercial rate represents a 24% increase over the federal baseline, which is a common markup structure for in-network care. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that the negotiated rate often exceeds the cash price of $1,892. If you have a high-deductible plan where your deductible has not yet been met, paying the cash price directly could result in significant savings compared to the insurance negotiated rate, provided you can afford the upfront cost.
To maximize potential savings, it is highly recommended to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling your appointment. These discounts, which can range from 20% to 50%, are incentives for patients who pay their bill in full upfront, bypassing the administrative costs associated with insurance claims processing. Additionally, because over 80% of hospital bills contain errors, you should request a detailed, itemized statement rather than accepting a summary bill. This allows you to verify that all charges correspond to services actually rendered and to identify any unbundled codes or services not provided. If you receive a balance bill for out-of-network ancillary services, you may be entitled to protections under the No Surprises Act, which prevents