CT scan, sinuses
Facility: Salina Regional Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $2,432
- Cash Discount Price: $1,892
- vs. Medicare Baseline: 22.77x 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 2277% of the Medicare baseline (a markup of 2177%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $479 - $504 | 448% |
| Preferred Phsic | $1,622 | 1519% |
| Preferred Healthcare - All Other Plans | $2,189 | 2049% |
| Providers Care (Wppa)-All Plans | $2,432 | 2277% |
| Multiplan (Mpi)-All Plans | $2,432 | 2277% |
| Aetna | $2,432 | 2277% |
| Cigna | $2,432 | 2277% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Salina Regional Health Center in Salina, Kansas, the facility's cash median price is $1,892, which is lower than the negotiated rates paid by major insurers like Preferred Healthcare ($2,189) and Aetna ($2,432). While the facility's negotiated rate of $2,432 is significantly higher than the Medicare benchmark of $106.81, indicating a substantial markup common in commercial contracts, patients with high-deductible plans might find paying the cash price of $1,892 more cost-effective than relying on insurance, which could result in balance billing if the patient's plan does not cover the full negotiated amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full chargemaster rate.
The facility's pricing structure reflects standard commercial dynamics where administrative costs and contract negotiations often drive rates well above the true cost of care, as evidenced by the gap between the Medicare rate and the negotiated amounts. Although the data does not provide specific county or state average comparisons for this procedure, the significant difference between the cash price and the insurer-paid rates highlights the importance of understanding one's deductible status before using insurance. To avoid unexpected costs, patients should request an itemized billing audit if they receive a summary bill, ensuring no unbundled codes or services not rendered are included, and should formally dispute any balance bills in writing rather than accepting them immediately. By comparing the