CT scan, sinuses
Facility: Mitchell County Hospital Health Systems
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,358
- Cash Discount Price: $1,286
- vs. Medicare Baseline: 12.71x 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 1271% of the Medicare baseline (a markup of 1171%). 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 | $107 - $1,429 | 100% |
| Blue Cross Blue Shield | $458 | 429% |
| Triwest Well Mark All Plans | $1,215 | 1138% |
| First Health-All Plans | $1,286 | 1204% |
| Aetna | $1,286 | 1204% |
| Pref Hlth Care Sytms Comm - All Plans | $1,286 | 1204% |
| Phc Leased Ntwrk Access - All Plans | $1,358 | 1271% |
| Multiplan Ppo - All Plans | $1,358 | 1271% |
| Auxiant-All Plans | $1,358 | 1271% |
| Cigna | $1,415 | 1325% |
| Health Partners Ks-All Plans | $1,415 | 1325% |
Consumer Guidance & Cost Commentary
For this CT scan of the sinuses at Mitchell County Hospital Health Systems in Beloit, KS, the cash price is $1,286, which matches the median negotiated rate for most major payers. This cash price is significantly lower than the facility's gross charge of $1,429, offering potential savings for patients with high-deductible plans who may not have met their insurance threshold. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should verify their specific plan's deductible status before assuming insurance will cover the full cost, as some in-network contracts can result in higher out-of-pocket expenses than paying cash directly.
To avoid unexpected balance billing, patients should request an itemized bill that breaks down every CPT code and service rendered, as summary bills often hide unbundled charges or services not received. If you receive a surprise bill for out-of-network ancillary services at this in-network facility, you may be protected under the No Surprises Act, which prohibits balance billing for emergency and non-emergency care. Additionally, since the facility offers a prompt-pay discount for upfront payment, you can often reduce your final bill by 20% to 50% by paying in full before or shortly after your visit, bypassing the administrative costs and delays associated with insurance claims processing.