CT scan, sinuses
Facility: Memorial Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,486
- Cash Discount Price: $2,703
- vs. Medicare Baseline: 13.91x 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 1391% of the Medicare baseline (a markup of 1291%). 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 | $484 | 453% |
| Humana | $1,351 | 1265% |
| Tricare | $1,351 | 1265% |
| Medicare (plans) | $1,365 | 1278% |
| Ambetter / Centene | $1,486 | 1391% |
| Coventry - All Other Plans | $2,432 | 2277% |
| Preferred Healthcare-All Plans | $2,567 | 2403% |
| Health Partners Of Kansas - All Plans | $2,567 | 2403% |
| Wppa/Providers Care-All Plans | $3,784 | 3543% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Memorial Hospital in Abilene, KS, the cash price is $2,703, which matches the facility's median negotiated rate of $1,486 for most major payers like Blue Cross Blue Shield and Humana. While the hospital's cash price is significantly higher than the Medicare benchmark of $106.81, it is important to note that commercial insurance rates often exceed cash prices due to administrative costs and contract structures. In this specific case, the cash price is actually higher than the negotiated rates paid by insurers, meaning patients with high-deductible plans might save money by paying the lower negotiated amount directly or by utilizing their insurance, provided they have met their deductible.
Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, it is crucial to verify network status before scheduling. If you are self-pay, you should explicitly ask the hospital about "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid upfront, bypassing the costly insurance claims process. Additionally, since over 80% of hospital bills contain errors, do not accept a summary bill as final; instead, request a full itemized statement to identify any unbundled codes or services not rendered before making any payment.