CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health and Rideout

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $3,016
Cash Discount Price: $903
vs. Medicare Baseline: 28.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health and Rideout is $3,016. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $903. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 28.24x the Medicare baseline. Located in 726 4Th St, Marysville, CA.

Cash / Self-Pay

$903

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,016

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: $903 (845%)

Insurance Median: $3,016 (2824%)

Cash: $903 (845% of Medicare)

Ins. Median: $3,016 (2824% 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 2824% of the Medicare baseline (a markup of 2724%). 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
Bc Mcal	$97	91%
Kaiser Mcr Adv	$135	126%
Tricare	$135	126%
UnitedHealthcare	$135 - $4,074	126%
Blue Cross Blue Shield	$136 - $1,657	127%
Kaiser Mcal	$209	196%
Medi-Cal	$209	196%
Ah Employee Health Plan - All Plans	$243	228%
Ca Health And Wellness- All Plans	$259	242%
Celtic Mcaid-All Plans	$259	242%
Healthnet Mcal	$704 - $938	659%
Healthnet Comm-All Other Plans	$2,262 - $3,016	2118%
Aetna	$2,487 - $3,316	2328%
Kaiser-All Other Plans	$2,674 - $3,564	2504%
Blue Shield Uc Care Members	$2,814 - $3,752	2635%
Cigna	$2,998 - $3,997	2807%
First Health-All Plans	$3,078 - $4,104	2882%
Phcs-All Plans	$3,096 - $4,127	2899%
Interplan-All Plans	$3,166 - $4,221	2964%
Blue Shield-All Other Plans	$3,342 - $4,456	3129%
Multiplan-All Plans	$3,342 - $4,456	3129%
Partnership Hp Mcal -All Plans	$5,805 - $7,738	5435%

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 $903.
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 Adventist Health and Rideout 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.