CT scan, sinuses
Facility: Hodgeman County Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,192
- Cash Discount Price: $1,354
- vs. Medicare Baseline: 11.16x 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 1116% of the Medicare baseline (a markup of 1016%). 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 | $435 - $458 | 407% |
| UnitedHealthcare | $1,084 - $1,608 | 1015% |
| Triwest - All Plans | $1,084 | 1015% |
| Medicaid / KanCare | $1,084 - $1,693 | 1015% |
| Humana | $1,084 | 1015% |
| Aetna | $1,354 | 1268% |
| First Health - All Plans | $1,524 | 1427% |
| Health Partners - All Plans | $1,608 | 1505% |
| Wppa (Provdrscare) - All Plans | $1,608 | 1505% |
Consumer Guidance & Cost Commentary
For the CT scan of the sinuses (CPT 70486) at Hodgeman County Health Center in Jetmore, KS, the facility's cash median rate is $1,354, which aligns with the cash median for this procedure in the state. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates vary significantly by insurer, ranging from $1,084 for Triwest and Humana to $1,693 for Blue Cross Blue Shield. It is important to note that for patients with high-deductible plans, paying the cash price of $1,354 upfront may be more cost-effective than relying on insurance, as the negotiated rates for some payers exceed the cash amount. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final cost.
The Medicare benchmark for this service is $106.81, which serves as the objective baseline for evaluating pricing fairness. The facility's cash rate is approximately 1,267% higher than the Medicare amount, reflecting the typical administrative and operational costs of commercial care. Although the data does not provide specific county or state average comparisons for this exact procedure, the wide variation in negotiated rates across nine different payers highlights the importance of verifying your specific plan's allowed amount. If you receive a bill that exceeds the negotiated rate or the cash price, you should request an itemized billing audit to identify any errors, such as unbundled codes or services not rendered, and dispute the charges in writing if necessary.