CT scan, sinuses
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $98
- Cash Discount Price: $577
- vs. Medicare Baseline: 0.92x 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 | $33 - $275 | 31% |
| Aetna | $35 - $94 | 33% |
| Medicaid / KanCare | $35 - $140 | 33% |
| Providrs Care | $54 - $175 | 51% |
| Humana | $98 - $99 | 92% |
| Va | $98 | 92% |
| Medicare (plans) | $98 - $100 | 92% |
| Smarthealth | $138 | 129% |
| Ambetter / Centene | $167 | 156% |
| Tricare | $174 | 163% |
| Blue Cross Blue Shield | $520 - $548 | 487% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Ascension Via Christi Hospital Manhattan, the cash price is $577, which is significantly lower than the facility's gross charge of $1,442. While the hospital offers a negotiated rate of $98 for in-network patients, this amount is still higher than the cash price, suggesting that self-pay patients with high-deductible plans might save money by paying out-of-pocket and requesting a prompt-pay discount before scheduling. It is important to note that commercial insurance rates often include administrative costs and contract markups, making the cash rate a more direct reflection of the service cost. Patients should verify their specific plan details, as some policies may cover the cash price even if the negotiated rate is higher, and they should explicitly ask for self-pay pricing at registration to avoid unexpected charges.
The facility's pricing is benchmarked against Medicare, which sets a baseline rate of $106.81 for this procedure. The cash price of $577 represents a markup relative to this federal standard, which is typical for commercial pricing structures that account for local wage indexes and facility overhead. While the data does not provide specific state or county average comparisons for this exact code, the facility's ownership as a voluntary non-profit private hospital may influence its pricing strategy compared to for-profit competitors. Consumers are advised to review their itemized bills carefully, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered, and to dispute any balance billing immediately if they receive a bill from an out-of-network provider at this in-network facility, which is generally prohibited under federal law.