CMS Price Transparency Data

CT scan, sinuses

Facility: Sonoma Valley Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $2,397
  • Cash Discount Price: $3,503
  • vs. Medicare Baseline: 22.44x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Sonoma Valley Hospital is $2,397. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,503. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 22.44x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$3,503

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,397

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: $3,503 (3280%)
Insurance Median: $2,397 (2244%)
Cash: $3,503 (3280% of Medicare)
Ins. Median: $2,397 (2244% 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 2244% of the Medicare baseline (a markup of 2144%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $141 132%
Blue Cross Blue Shield $144 - $3,283 135%
Bright Hlth/Brand New Day Mcr Adv $144 135%
Hospice Of Marin-All Plans $144 135%
St Joseph Heritage Hltcare Comm-All Other Plans $144 135%
Veterans Admin-All Plans $144 135%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $151 141%
Cdcr Prison-All Plans $173 162%
Three Rivers (Trpn)-All Plans $173 162%
Chp - Correctional Health Partners - All Plans $187 175%
Bright Hlth/Brand New Day - All Other Plands $194 182%
Wellpath - All Plans $201 188%
Medi-Cal $209 196%
Aetna $222 208%
First Health(Coventry)-All Plans $222 208%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $259 242%
Canopy Health Solutions-All Other Plans $259 242%
Mcal Mgd Care (Php)-All Plans $344 322%
UnitedHealthcare $486 455%
Partnership Healthplan-All Plans $731 684%
Comm Care Network(Ccn)-All Plans $1,000 936%
Healthnet Hmo/Ppo-All Other Plans $1,952 1828%
Blue Shield Ppo-All Plans $2,842 2661%
Kaiser-All Plans $3,253 3046%
Integrated Health Plan-All Plans $3,703 3467%
Champus-All Plans $4,003 3748%
Cigna $4,003 3748%
Networks By Design - All Plans $4,003 3748%
Great West-One Health Plan Ppo/Pos-All Plans $4,253 3982%
Phcs/Multiplan/Beech St-All Plans $4,253 3982%
Interplan-All Plans $4,404 4123%
Bps-All Plans $4,504 4217%
Ppo Alliance-All Plans $4,504 4217%
Pref Health Networl(Phn)-All Plans $4,504 4217%
Meritage Medical Network Op Only Mcare $5,004 4685%
Scan Mcare-All Plans $5,004 4685%
St Joseph Heritage Hltcare Mcr Adv $5,004 4685%
Correct Care Integ Health-All Plans $6,005 5622%
Employer Direct Healthcare-All Plans $6,005 5622%
Meritage Medical Network Op Only-All Other Plans $6,305 5903%
Creative Legal Services-All Plans $6,505 6090%
Canopy Op Only $9,007 8433%
Vnpn - All Plans $9,007 8433%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals