CT scan, sinuses
Facility: Fredonia Regional Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $596
- Cash Discount Price: $662
- vs. Medicare Baseline: 5.58x 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 558% of the Medicare baseline (a markup of 458%). 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 | $327 - $480 | 306% |
| UnitedHealthcare | $337 - $596 | 316% |
| Aetna | $337 - $596 | 316% |
| Veterans Programs - All Plans | $337 | 316% |
| Reserve National-All Plans | $596 | 558% |
| Meritain-All Plans | $596 | 558% |
| Cigna | $596 | 558% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Fredonia Regional Hospital in Kansas, the cash price is $662.00, which matches the facility's median negotiated rate of $596.00 and the median paid amount. This cash price is significantly higher than the Medicare benchmark of $106.81, reflecting a markup of 5.6 times the federal rate. While commercial payers like Blue Cross Blue Shield and UnitedHealthcare negotiate rates ranging from $327 to $596, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $662.00. It is important to verify your specific plan's allowed amount before scheduling, as assuming in-network coverage guarantees the lowest price can lead to unexpected costs if the negotiated rate is higher than the cash option.
To ensure you are not overcharged, request a full itemized bill that lists every CPT code and unit cost rather than accepting a summary invoice that obscures individual charges. Since over 80% of hospital bills contain errors, such as unbundled services or charges for items not rendered, a line-by-line review is the most effective way to identify and dispute mistakes. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing. Always confirm whether your specific procedure is covered under your plan's deductible before proceeding, as paying the full negotiated rate without meeting your deductible balance can result in significantly higher out-of-pocket expenses.