CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Reedley

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $160
  • Cash Discount Price: $451
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Reedley is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.50x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$451

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $451 (422%)
Insurance Median: $160 (150%)
Cash: $451 (422% of Medicare)
Ins. Median: $160 (150% 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.

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
Cigna $22 - $2,057 21%
Blue Shield Mcare $40 - $134 37%
Fhcn Pace Mcr Adv-All Plans $40 - $134 37%
Lasalle Med Assoc Profee Only - All Plans $40 37%
Tricare $40 - $134 37%
UnitedHealthcare $40 - $1,330 37%
Upn Mcr Adv Profee Only $40 37%
Ah Employee Health Plan - All Plans $44 - $242 41%
Community Care Ipa Mcal-All Plans $49 - $271 46%
Kaiser - All Other Plans $55 - $1,582 51%
Kaiser Mcr Adv $55 - $134 51%
Healthnet- All Other Plans $59 - $1,376 55%
Western Growers/Pinnacle- All Plans $60 - $1,455 56%
Blue Shield Epn - All Other Plans $73 - $1,398 68%
Blue Shield Non Epn $77 - $1,620 72%
Blue Cross Blue Shield $100 - $1,172 94%
Bc Mcal $121 - $123 113%
Cal Viva Hlth Mcal - All Plans $123 - $209 115%
Central Ca Alliance Mcal Profee Only $123 115%
Dignity Mcal Op/Profee Only-All Other Plans $123 - $230 115%
Medi-Cal $123 - $209 115%
Upn Mcal Profee Only-All Other Plans $123 115%
Physicians Med Group Op/Profee Only- All Plans $128 - $2,531 120%
Dignity Mcr Adv Op/Profee Only $134 125%
Healthnet- Mcr Adv $134 125%
Phs Prime Health Srvcs $134 125%
Kern Health Systems Mcal-All Plans $154 - $209 144%
Central Ca Alliance Ccs Profee Only $160 150%
Central Ca Alliance Chdp Profee Only $160 150%
Central Ca Alliance Comm Profee Only - All Other P $160 150%
Aetna $178 - $2,199 167%
Bright Health Mcr Adv - All Plans $211 198%
Healthnet Medi-Cal $356 - $475 333%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals