CMS Price Transparency Data

CT scan, sinuses

Facility: Lompoc Valley Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $961
Cash Discount Price: $999
vs. Medicare Baseline: 9.00x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Lompoc Valley Medical Center is $961. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $999. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.00x the Medicare baseline. Located in 1515 E Ocean Avenue, Lompoc, CA.

Cash / Self-Pay

$999

Average discount available for prompt cash payment at this facility.

Insurance Median

$961

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: $999 (935%)

Insurance Median: $961 (900%)

Cash: $999 (935% of Medicare)

Ins. Median: $961 (900% 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 900% of the Medicare baseline (a markup of 800%). 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	$134 - $1,918	125%
Blue Cross Blue Shield	$134 - $672	125%
Blue_Shield	$134	125%
Coventry	$134 - $1,918	125%
Health_Net	$134	125%
Humana	$134	125%
Medicare (plans)	$134	125%
Sansum	$134	125%
UnitedHealthcare	$134 - $1,864	125%
Work_Comp	$161	151%
Magellan	$532 - $1,598	498%
Blue_Shield_National	$870 - $1,056	815%
Cigna	$887 - $2,430	830%
Medi_Cal	$887 - $2,664	830%
Tricare	$887 - $2,664	830%

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 $999.
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 Lompoc Valley Medical Center 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.