CMS Price Transparency Data

CT scan, sinuses

Facility: Pawhuska Hospital, Inc

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $914
Cash Discount Price: $721
vs. Medicare Baseline: 8.56x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Pawhuska Hospital, Inc is $914. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $721. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.56x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$721

Average discount available for prompt cash payment at this facility.

Insurance Median

$914

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: $721 (675%)

Insurance Median: $914 (856%)

Cash: $721 (675% of Medicare)

Ins. Median: $914 (856% 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 856% of the Medicare baseline (a markup of 756%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Community Care Comm - All Plans	$267	250%
Healthchoice Ip/Op Only - All Plans	$336	315%
Blue Cross Blue Shield	$649 - $1,057	608%
Aetna	$721 - $1,243	675%
Tricare	$721	675%
UnitedHealthcare	$721 - $895	675%
Wellcare Mcr Adv - All Plans	$721	675%
Humana	$728 - $1,243	682%
Healthcare Highways - All Plans	$808	756%
Cigna	$845	791%
Multiplan - All Plans	$932	873%
Ambetter / Centene	$1,081	1012%
Preferred Commchoice Ip/Op Only - All Plans	$1,119	1048%
Soonerselect Mcaid - All Plans	$1,243	1164%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $721.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 70486.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Pawhuska Hospital, Inc is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 70486.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.