CMS Price Transparency Data

CT scan, sinuses

Facility: Oak Valley Hospital District

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $960
Cash Discount Price: $1,242
vs. Medicare Baseline: 8.99x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Oak Valley Hospital District is $960. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,242. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.99x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$1,242

Average discount available for prompt cash payment at this facility.

Insurance Median

$960

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: $1,242 (1163%)

Insurance Median: $960 (899%)

Cash: $1,242 (1163% of Medicare)

Ins. Median: $960 (899% 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 899% of the Medicare baseline (a markup of 799%). 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
Alignment Op Only Ip/Op Only-All Plans	$134	125%
Humana	$134	125%
Kaiser Mcr Adv Ip/Op Only	$134	125%
Scan Health Plan Ip/Op Only-All Plans	$137	128%
Imperial Health Ip/Op Only-All Plans	$148	139%
Blue Cross Blue Shield	$209 - $1,490	196%
Healthnet Medi-Cal Ip/Op Only	$209	196%
Kaiser Medi-Cal Ip/Op Only	$209	196%
Medi-Cal Ip/Op Only	$209	196%
Hp Of San Joaquin Ip/Op Only-All Plans	$250	234%
Blue Shield Epn Ip/Op Only	$896	839%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$960	899%
Kaiser Comm Ip/Op Only-All Other Plans	$1,027	962%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$1,093	1023%
Cigna	$1,110	1039%
UnitedHealthcare	$1,159	1085%
Aetna	$1,409	1319%

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 $1,242.
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 Oak Valley Hospital District 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.