CMS Price Transparency Data

CT scan, sinuses

Facility: Watsonville Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $3,500
  • Cash Discount Price: $3,924
  • vs. Medicare Baseline: 32.77x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Watsonville Community Hospital is $3,500. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,924. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 32.77x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$3,924

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,500

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: $3,924 (3674%)
Insurance Median: $3,500 (3277%)
Cash: $3,924 (3674% of Medicare)
Ins. Median: $3,500 (3277% 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 3277% of the Medicare baseline (a markup of 3177%). 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
Alliance/Sccho $171 160%
California Childrens Srvs $177 166%
Ccs/Monterey County $177 166%
Healthy Families $177 166%
Medi-Cal E.R. $177 166%
Medi-Cal/Eds $177 166%
Medicaid / KanCare $177 166%
Well Path $177 - $6,540 166%
Aetna $411 - $4,500 385%
Blue Cross Blue Shield $411 - $5,827 385%
Blue Shield Hmo $411 - $1,308 385%
Cigna $411 - $4,578 385%
Great-West/Phcs $411 - $4,578 385%
Health Net Pmg Hmo $411 - $4,101 385%
Pacificare Hmo $411 - $3,100 385%
Secure Horizons Dign Hmo $411 - $1,308 385%
UnitedHealthcare $411 - $3,100 385%
Calif Ironworkers Field $897 - $5,827 840%
Carpenters H&W Trust $897 - $5,827 840%
City Of Wats/Pinnacle Clm $897 - $5,827 840%
Claims Management Wc $897 - $5,827 840%
Delta Health Systems $897 - $5,827 840%
Laborers Health & Welfare $897 - $5,827 840%
Monterey Bay Pub Emp Trst $897 - $5,827 840%
Operating Engineers $897 - $5,827 840%
Pinnacle Claims Tpa/Bc $897 - $5,827 840%
Robert Kennedy/Ccn $897 - $5,827 840%
Sheet Metal Workers $897 - $5,827 840%
State Compensation Fund $897 - $5,827 840%
Teamsters Benefit Trust $897 - $5,827 840%
Western Growers Trust/Bc $897 - $5,827 840%
Medicruz $1,177 1102%
Victim Compensation Plan $1,177 - $6,540 1102%
Health Net Smartcare Netw $1,525 - $3,100 1428%
Pacificare Ppo $1,525 - $3,100 1428%
Adventist Risk Management $3,200 - $5,232 2996%
First Health $3,200 - $5,232 2996%
Geha (Ccn) $3,200 - $5,232 2996%
Transwestern $3,200 - $5,232 2996%
Western Health Advantage $3,270 3062%
Self Pay $3,924 3674%
Health Net Blue And Gold $4,101 3840%
Health Net Canopycare Hmo $4,101 3840%
Health Net Of California $4,101 3840%
Multiplan Inc Ppo $5,102 4777%
Private Healthcare System $5,102 4777%
Coastal Healthcare Admin $5,559 - $5,886 5205%
Salinas Valley Mem Hops $5,559 5205%
Aaa $6,540 6123%
Aarp $6,540 6123%
Allstate $6,540 6123%
Apwu Health Plan $6,540 6123%
Bankers Life & Casualty $6,540 6123%
Farmers Insurance $6,540 6123%
Humana $6,540 6123%
Miscellaneous Auto $6,540 6123%
Miscellaneous Insurance $6,540 6123%
North Calif Bakery Driver $6,540 6123%
Physicians Mutual $6,540 6123%
Prucare Pmg Hmo $6,540 6123%
Prucare Pmg Pos $6,540 6123%
State Farm Ins $6,540 6123%
Sutter Health Plus $6,540 6123%
Travelers Insurance $6,540 6123%
United Administrative $6,540 6123%
Wholesale Beer Distributo $6,540 6123%
Zenith National Ins $6,540 6123%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 75 Nielson Street, Watsonville, CA 95076
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals