CT scan, sinuses
Facility: Lincoln County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $480
- Cash Discount Price: $1,193
- vs. Medicare Baseline: 4.49x 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 449% of the Medicare baseline (a markup of 349%). 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 | 449% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Lincoln County Hospital in Lincoln, KS, the facility's cash price is $1,193, which is lower than the negotiated rate of $480 paid by Blue Cross Blue Shield. This specific procedure is priced at 4.5 times the Medicare benchmark of $106.81, reflecting the typical markup found in commercial contracts. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more affordable than relying on insurance, as the negotiated rate often exceeds the cash amount. To secure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill.
It is important to understand that the $480 rate represents a contractual ceiling for in-network members, not necessarily the best price available for self-pay. Because insurance billing involves complex administrative processing and potential claim denials, paying cash upfront can bypass these costs entirely. If you choose to use insurance, be aware that your plan's deductible status determines how much you owe, and the facility's administrative overhead is baked into the negotiated rate. Conversely, if you pay out-of-pocket, you avoid the administrative fees that inflate commercial rates. Always verify your specific plan details and request a written confirmation of any cash discounts before providing payment information to ensure you are not inadvertently agreeing to higher insurance-driven charges.