CMS Price Transparency Data

CT scan, sinuses

Facility: Grossmont Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,356
Cash Discount Price: $2,850
vs. Medicare Baseline: 22.06x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Grossmont Hospital is $2,356. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,850. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.06x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$2,850

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,356

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: $2,850 (2668%)

Insurance Median: $2,356 (2206%)

Cash: $2,850 (2668% of Medicare)

Ins. Median: $2,356 (2206% 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 2206% of the Medicare baseline (a markup of 2106%). 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
Aetna	$24 - $2,850	22%
Health Net	$375 - $2,850	351%
County Medical Services	$570	534%
Molina	$570 - $2,280	534%
Blue Cross Blue Shield	$626 - $2,660	586%
Multiplan	$626 - $2,090	586%
UnitedHealthcare	$1,596	1494%
Allianz Global Assistance	$2,356	2206%
Managed Health Network	$2,413	2259%
San Diego Pace	$2,622	2455%
Epic Americas	$2,660	2490%
Humana	$2,660 - $3,116	2490%
Indian Health Council	$2,850	2668%
Medicare (plans)	$2,850	2668%
Interplan	$2,926	2739%
California Health And Wellness	$3,040	2846%
Community Health Group	$3,116	2917%
Kaiser	$3,420	3202%

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 $2,850.
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 Grossmont Hospital 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.