CT scan, sinuses
Facility: Bob Wilson Memorial Hospital
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $1,990
- Cash Discount Price: $974
- vs. Medicare Baseline: 18.63x 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 1863% of the Medicare baseline (a markup of 1763%). 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 |
|---|---|---|
| Centura Employee Plan | $337 | 316% |
| Blue Cross Blue Shield | $641 | 600% |
| Aetna | $779 - $1,948 | 729% |
| UnitedHealthcare | $779 - $2,031 | 729% |
| Kansas Health | $779 | 729% |
| Humana | $779 | 729% |
| Medicare (plans) | $779 | 729% |
| Multiplan | $2,192 - $2,265 | 2052% |
| Health Partners Of Kansas | $2,289 | 2143% |
| Wppa | $2,314 | 2166% |
Consumer Guidance & Cost Commentary
For this CT scan of the sinuses at Bob Wilson Memorial Hospital in Ulysses, Kansas, the cash payment rate of $974 is significantly lower than the facility's gross charge of $2,435 and the Medicare benchmark of $106.81, which serves as the objective baseline for evaluating hospital pricing markups. While the hospital operates as a voluntary non-profit church-owned Critical Access Hospital, patients should be aware that commercial negotiated rates often exceed cash prices due to administrative structures and contract dynamics; in this case, the median negotiated rate of $1,990 and the median paid rate of $614 reflect the specific payer contracts, with some plans like Aetna and UnitedHealthcare having wide ranges between their high and low allowable amounts.
To minimize out-of-pocket costs, consumers should verify if their specific insurance plan falls within the range of the 10 payers listed for this service, noting that some plans have identical high and low rates while others, such as Multiplan and Health Partners Of Kansas, show variations between $2,192 and $2,289. If your insurance deductible has not yet been met, you may avoid paying the full negotiated amount, but if you have a high-deductible plan, paying the cash price of $974 upfront could be more cost-effective than the insurance negotiated rate, provided you can secure a prompt-pay discount. It is essential to request a self-pay or prompt-pay discount before scheduling to bypass costly claims processing and administrative fees, ensuring you receive the most accurate and favorable rate available for this procedure.