CT scan, sinuses
Facility: Amberwell Atchison Association
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $678
- Cash Discount Price: $1,325
- vs. Medicare Baseline: 6.35x 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 635% of the Medicare baseline (a markup of 535%). 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 |
|---|---|---|
| Triwest - All Plans | $437 | 409% |
| Humana | $437 - $581 | 409% |
| Superior Select Mcr Adv - All Plans | $437 | 409% |
| UnitedHealthcare | $437 - $2,377 | 409% |
| Va Ccn - All Plans | $437 | 409% |
| Blue Cross Blue Shield | $456 - $480 | 427% |
| Ambetter / Centene | $678 | 635% |
| Cigna | $729 | 683% |
| Aetna | $729 | 683% |
| Oscar - All Plans | $994 | 931% |
| Centrus Health Direct - All Plans | $994 | 931% |
| Multiplan - All Plans | $1,034 | 968% |
| Wppa Providrs Care - All Plans | $1,192 | 1116% |
Consumer Guidance & Cost Commentary
For the CT scan of the sinuses at Amberwell Atchison Association, the cash price is $1,325.00, which matches the facility's cash median. This cash rate is significantly higher than the state average for this procedure, as indicated by the 6.3% variance compared to Medicare benchmarks. While the facility is a Critical Access Hospital in Atchison, KS, and operates as a voluntary non-profit, patients with high-deductible plans may find paying the cash price upfront more economical than relying on insurance. In this case, the median negotiated rate across 13 payers is $678.00, which is lower than the cash price, suggesting that using insurance could result in a lower out-of-pocket cost once deductibles and copays are applied, provided the patient's plan covers the service.
It is important to note that commercial insurance rates vary widely among the 13 payers, ranging from a low of $437.00 with Triwest to a high of $1,192.00 with WPPA Providers Care. The No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, though patients should still verify their specific plan details before scheduling. To maximize savings, patients should explicitly request a "self-pay" or "prompt-pay" discount before check-in, as these upfront payment incentives can reduce the total bill by 20% to 50%. If a patient receives an itemized bill, they should request a full line-by-line audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills