CMS Price Transparency Data

CT scan, sinuses

Facility: City of Hope National Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,223
Cash Discount Price: $1,748
vs. Medicare Baseline: 11.45x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at City of Hope National Medical Center is $1,223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,748. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.45x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$1,748

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,223

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: $1,748 (1637%)

Insurance Median: $1,223 (1145%)

Cash: $1,748 (1637% of Medicare)

Ins. Median: $1,223 (1145% 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 1145% of the Medicare baseline (a markup of 1045%). 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
Health Net	$88 - $1,695	82%
Cal Optima	$104 - $173	97%
Heritage Provider Network	$130 - $1,223	122%
Inland Empire	$130 - $1,398	122%
Prime Healthcare Keenan	$182 - $1,678	170%
Healthcare Partners	$285	267%
UnitedHealthcare	$480 - $979	449%
Aetna	$715	669%
Blue Cross Blue Shield	$874 - $1,344	818%
Blue Shield	$1,035 - $2,083	969%
Blue Shield Covca	$1,062	994%
Blue Shield Promise	$1,223	1145%
Cencal	$1,398	1309%
La Care Health	$1,398	1309%
Kaiser	$1,573	1473%
Gold Coast	$1,748	1637%
Molina	$1,748 - $2,272	1637%
Cigna	$1,877	1757%
Facey	$1,922	1799%
St. Joseph Heritage	$2,097	1963%
Primecare Medical Network	$2,272	2127%
First Health	$2,691	2519%
Phcs Multiplan	$3,146	2945%

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 $1,748.
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 City of Hope National 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.