CT scan, sinuses
Facility: Phillips County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $572
- Cash Discount Price: $537
- vs. Medicare Baseline: 5.36x 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 536% of the Medicare baseline (a markup of 436%). 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 | $480 - $512 | 449% |
| UnitedHealthcare | $506 - $632 | 474% |
| Health Partners-All Plans | $632 | 592% |
| Medicaid / KanCare | $632 | 592% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Phillips County Hospital in Phillipsburg, KS, the negotiated rates range from $480 to $632 depending on your specific insurance plan, with Blue Cross Blue Shield offering the lowest allowed amount at $480. This facility is a Critical Access Hospital owned by the local government, and while the cash median price is $537, your commercial insurance will likely pay a negotiated rate between $506 and $632. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though the cash median here is slightly lower than the highest negotiated rate. Additionally, this facility's pricing is significantly higher than the Medicare benchmark of $106.81, reflecting the standard commercial markup structure where negotiated rates often exceed the federal baseline.
Before scheduling, you should verify your deductible status, as patients who have not yet met their plan's deductible may be responsible for the full negotiated amount rather than a lower copay. If you choose to pay out-of-pocket, ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Since over 80% of hospital bills contain errors, do not accept a summary invoice as your final charge; instead, request a detailed, itemized statement showing every specific CPT code and unit cost to identify any unbundled charges or services not rendered. Finally, be aware that while the No Surprises Act protects you from balance billing for emergency care at in-network facilities, it is crucial to confirm that all anc