CT scan, sinuses
Facility: Wamego Health Center
Billing Code: 70486 (CPT)
- CPT Billing Code: 70486
- Insurance Median: $83
- Cash Discount Price: $740
- vs. Medicare Baseline: 0.78x 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 - $91 | 31% |
| Aetna | $35 - $94 | 33% |
| Medicaid / KanCare | $35 - $140 | 33% |
| Providrs Care | $54 - $175 | 51% |
| Tricare | $174 | 163% |
| Blue Cross Blue Shield | $631 - $664 | 591% |
Consumer Guidance & Cost Commentary
For a CT scan of the sinuses at Wamego Health Center, the cash price is $740, which is significantly lower than the facility's gross charge of $1,851. While insurance plans like UnitedHealthcare and Aetna negotiate rates ranging from $33 to $140, these amounts often exceed the cash price, meaning self-pay patients could save money by paying directly. The facility is a Critical Access Hospital in Wamego, Kansas, and while the data does not provide specific county or state averages for comparison, patients should note that commercial negotiated rates frequently include administrative overhead that can inflate the baseline price by 20% to 40% compared to the actual cost of care.
To minimize unexpected costs, patients should verify their deductible status before scheduling, as paying out-of-pocket may be more efficient if the insurance allowed amount is higher than the cash rate. If you receive a bill from an out-of-network provider, the No Surprises Act generally protects you from balance billing for emergency care and non-emergency services at in-network facilities, so you should dispute any surprise charges with your insurer rather than paying immediately. Additionally, always request a full itemized bill before agreeing to payment terms, as summary invoices can hide unbundled codes or services not rendered, and ask the hospital specifically about prompt-pay discounts that may reduce the final amount owed.