CT scan, sinuses
Facility: Community Memorial Healthcare, Inc.
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,172
- Cash Discount Price: $2,272
- vs. Medicare Baseline: 10.97x 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 1097% of the Medicare baseline (a markup of 997%). 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% |
| Aetna | $1,045 - $1,704 | 978% |
| UnitedHealthcare | $1,299 | 1216% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Community Memorial Healthcare in Marysville, Kansas, the cash median price is $2,272, which matches the facility's gross charge. This rate is significantly higher than the state average, as indicated by a 11% variance compared to Medicare benchmarks. While the facility offers a negotiated rate of $1,172 for in-network patients, this amount remains above the cash price, suggesting that self-pay patients with high-deductible plans might save money by paying directly. It is important to note that commercial insurance contracts often include administrative overheads that inflate the baseline price, and patients should verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
Patients should be aware that hospitals often issue summary bills that obscure individual line items, making it difficult to identify errors or unbundled charges. To protect against unexpected costs, consumers should request a full itemized CPT-coded bill before paying, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Additionally, since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should explicitly ask about "prompt-pay" discounts or self-pay rates prior to check-in, as paying upfront can sometimes bypass the costly insurance billing cycle and result in a lower final bill.