CT scan, sinuses
Facility: Scott County Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,200
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 11.23x 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 1123% of the Medicare baseline (a markup of 1023%). 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 | $60 - $1,380 | 56% |
| Blue Cross Blue Shield | $480 | 449% |
| Humana | $610 | 571% |
| Wppa | $872 - $1,200 | 816% |
| Aetna | $1,308 | 1225% |
Consumer Guidance & Cost Commentary
For the CPT code 70486 (CT scan, sinuses) at Scott County Hospital in Scott City, KS, the Medicare benchmark rate is $106.81. This federal baseline represents the scientifically validated cost of care, serving as the objective standard against which commercial rates are measured. While the facility's negotiated rates range from $480 to $1,380 depending on the insurance carrier, these figures are significantly higher than the Medicare amount, reflecting the administrative overhead and contract structures inherent in commercial billing. It is important to note that cash-pay rates are not listed for this service; however, patients with high-deductible plans should verify if paying out-of-pocket directly could result in lower costs than their insurance negotiated rate, as commercial contracts often include administrative layers that inflate the baseline price.
To minimize potential costs, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing. Additionally, since the facility is a Critical Access Hospital in a rural area, understanding the local pricing dynamics is crucial; while specific county or state average comparisons for this exact procedure are not provided in the current data, the Medicare rate serves as the only reliable benchmark for evaluating markup. Consumers are advised to request a full itemized bill containing specific CPT codes to identify any errors or unbundled charges, as over 80% of hospital bills contain discrepancies that can be resolved through a formal written audit dispute.