CT scan, sinuses
Facility: Children'S Mercy South
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $116
- Cash Discount Price: $871
- vs. Medicare Baseline: 1.09x 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.
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 | $35 - $2,335 | 33% |
| Healthy Blue | $37 - $273 | 35% |
| Medicaid / KanCare | $38 - $70 | 36% |
| Home State Health | $50 - $240 | 47% |
| Wppa Providrs Care | $52 - $2,259 | 49% |
| Healthlink | $52 - $3,058 | 49% |
| Cigna | $52 - $2,415 | 49% |
| Health Midwest Comprehensive Care | $55 - $2,262 | 51% |
| American Healthcare Alliance | $57 - $2,954 | 53% |
| Wellfit/Centrus | $76 - $2,259 | 71% |
| Centivo | $78 - $2,259 | 73% |
| Humana | $78 - $2,311 | 73% |
| Orscheln | $79 - $2,259 | 74% |
| Quiktrip | $80 - $2,262 | 75% |
| Nebraska Furniture Mart | $81 - $2,259 | 76% |
| Medica | $90 - $2,026 | 84% |
| Blue Cross Blue Shield | $100 - $2,572 | 94% |
| Multiplan | $100 - $2,641 | 94% |
| Aetna | $102 - $2,363 | 95% |
| Mercy Health | $113 - $2,606 | 106% |
| Coxhealth Network | $115 - $2,572 | 108% |
| Coventry Health Care Of Kansas | $130 - $2,572 | 122% |
| National Preferred Provider Network | $136 - $3,128 | 127% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Children's Mercy South in Overland Park, the cash price is $871, which is significantly lower than the gross charge of $1,815. While the facility's negotiated rates with insurance plans range from $35 to $3,128, the cash price often represents the most affordable option for patients with high-deductible plans, as insurance allowed amounts frequently exceed the cash rate. To ensure you receive the best possible price, it is essential to ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling your visit, as these upfront fee reductions can lower the total cost by 20% to 50%.
When evaluating the cost of this procedure, it is important to compare rates against the Medicare benchmark rather than the hospital's inflated list price. The Medicare amount for this service is $106.81, and the facility's negotiated rates average 116% of this benchmark, which aligns with fair pricing standards. Additionally, the cash price of $871 is notably higher than the state average for this procedure, suggesting that while the facility's negotiated rates are competitive relative to Medicare, patients should carefully review their specific insurance allowed amounts to determine if the commercial rate is truly lower than paying out-of-pocket.