CMS Price Transparency Data

CT scan, sinuses

Facility: Lafayette Regional Health Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,453
  • Cash Discount Price: $5,842
  • vs. Medicare Baseline: 22.97x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Lafayette Regional Health Center is $2,453. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,842. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.97x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$5,842

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,453

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$106.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $106.81 (100%)
Cash / Self-Pay: $5,842 (5470%)
Insurance Median: $2,453 (2297%)
Cash: $5,842 (5470% of Medicare)
Ins. Median: $2,453 (2297% of 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 2297% of the Medicare baseline (a markup of 2197%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
United $60 - $2,629 56%
Healthyblue $61 57%
Aetna $62 - $5,111 58%
Amerigroup $62 58%
Home State Health Plan $62 58%
Medicaid / KanCare $62 58%
Unicare $62 58%
Corvel Corporation $154 - $4,965 144%
Oha Network $156 - $2,921 146%
Ambetter / Centene $1,087 1018%
Nhc Advantage $1,110 1039%
Universal Healthcare $1,519 1422%
Humana $1,974 - $2,512 1848%
Blue Cross Blue Shield $2,220 - $5,842 2078%
College Park Family Care Center $2,512 2352%
Oscar $2,921 2735%
Cigna $3,337 - $4,171 3124%
Wppa Providrs Care Network $4,381 4102%
Multiplan $4,556 4266%
Coventry $4,662 4365%
Coventry Kc Mo $4,662 4365%
Cco, Inc. $4,965 4648%
Focus Healthcare Mgmt, Inc $5,257 4922%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals