CT scan, sinuses
Facility: Osborne County Memorial Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $933
- Cash Discount Price: $876
- vs. Medicare Baseline: 8.74x 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 874% of the Medicare baseline (a markup of 774%). 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 |
|---|---|---|
| UnitedHealthcare | $784 | 734% |
| Health Partners Of Kansas | $887 | 830% |
| Wppa | $979 | 917% |
| Blue Cross Blue Shield | $1,010 | 946% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Osborne County Memorial Hospital, the cash price is $876, which is lower than the facility's negotiated rates with major payers like UnitedHealthcare ($784) and Health Partners of Kansas ($887). While the cash rate is competitive, it is important to note that commercial insurance contracts often include administrative overheads that can make the negotiated amount higher than the cash price for patients with high-deductible plans. The facility, a Critical Access Hospital in Osborne, KS, lists a median negotiated rate of $933, which is higher than the cash option. Patients should verify their specific plan's deductible status before scheduling, as paying out-of-pocket might result in immediate savings if the insurance allowed amount exceeds the cash price. Additionally, asking the hospital directly about "self-pay" or "prompt-pay" discounts before check-in can sometimes lower the final cost further.
This service is benchmarked against the Medicare rate of $106.81, showing a significant markup typical of commercial billing structures. The facility's pricing is compared to state and county averages to ensure transparency, though specific county or state average figures were not provided in the data for this code. To avoid unexpected costs, consumers should request an itemized bill before paying, as summary bills often obscure individual charges or unbundled codes that could be disputed. If a balance bill arises from an out-of-network ancillary service, the No Surprises Act may protect the patient from paying the difference, so disputing such bills with the insurer is a critical step. Always confirm the exact CPT code and unit costs to ensure the billing aligns with the agreed-upon negotiated or cash rates.