CMS Price Transparency Data

CT scan, sinuses

Facility: Ventura County Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,298
  • Cash Discount Price: $1,614
  • vs. Medicare Baseline: 12.15x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Ventura County Medical Center is $1,298. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,614. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 12.15x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$1,614

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,298

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: $1,614 (1511%)
Insurance Median: $1,298 (1215%)
Cash: $1,614 (1511% of Medicare)
Ins. Median: $1,298 (1215% 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 1215% of the Medicare baseline (a markup of 1115%). 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.

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
Tricare $130 122%
Alignment Hp - All Plans $134 125%
Blue Shield Mcr Adv $134 125%
Humana $134 125%
UnitedHealthcare $138 - $1,984 129%
Healthnet Mcr Adv $141 132%
Clinicas Mcr Adv $153 143%
Americas Hp Mcr Adv Ip/Op Only $155 145%
Scan-All Plans $161 151%
Western Growers-All Plans $168 157%
Clinicas Comm - All Other Plans $175 164%
Imperial-All Plans $175 164%
Ntwrk Provdrs-All Plans $175 164%
Americas Hp Comm Ip/Op Only-All Other Plans $202 189%
Hpn Ip/Op Only Medi-Cal $209 196%
Kaiser Medi-Cal Ip/Op Only $209 196%
Medi-Cal $209 196%
Kaiser Mcal Pediatric Ip/Op Only $230 215%
Clinicas Mcal $261 244%
Americas Hp Mcal Ip/Op Only $271 254%
Gold Coast Medi-Cal-All Plans $368 345%
Vchcp-All Plans $538 - $689 504%
Blue Shield Comm - All Other Plans $544 509%
Blue Shield Epn $1,099 - $1,406 1029%
Cigna $1,190 1114%
Healthnet Comm-All Other Plans $1,558 - $1,994 1459%
Kaiser Comm Pediatric Ip/Op Only $1,558 - $1,994 1459%
Aetna $1,643 - $3,625 1538%
Blue Cross Blue Shield $1,703 - $3,354 1594%
Multiplan/Claritev-All Plans $2,266 - $2,900 2122%
Three Rivers Ip/Op Only-All Plans $2,266 - $2,900 2122%
Ppo Next Ip/Op Only-All Plans $2,549 - $3,262 2386%
Kaiser Mcr Pediatric Ip/Op Only $2,832 - $3,625 2651%
Medicare (plans) $2,832 - $3,625 2651%
Hpn Comm Ip/Op Only-All Other Plans $4,021 - $5,148 3765%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals