CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Ukiah Valley

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,209
Cash Discount Price: $581
vs. Medicare Baseline: 11.32x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Ukiah Valley is $1,209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.32x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$581

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,209

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: $581 (544%)

Insurance Median: $1,209 (1132%)

Cash: $581 (544% of Medicare)

Ins. Median: $1,209 (1132% 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 1132% of the Medicare baseline (a markup of 1032%). 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
Cigna	$22 - $3,019	21%
Blue Shield Mcr Adv	$40 - $144	37%
Kaiser Mcr Adv	$40 - $144	37%
Tricare	$40 - $144	37%
Ah Employee Health Plan - All Plans	$44 - $259	41%
UnitedHealthcare	$53 - $3,236	50%
Healthnet-All Plans	$59 - $2,214	55%
Western Growers-All Plans	$60 - $1,626	56%
Blue Shield Epn-All Other Plans	$73 - $1,167	68%
Blue Shield Non-Epn	$77 - $1,198	72%
Mendocino Lcc District-All Plans	$104 - $2,516	97%
Kaiser Medi-Cal	$123 - $209	115%
Medi-Cal	$123 - $209	115%
Kaiser-All Other Plans	$128 - $3,097	120%
Three Rivers-All Plans	$144 - $3,484	135%
Aetna	$178 - $1,160	167%
Blue Cross Blue Shield	$767 - $1,023	718%
Foundation For Medical Care-All Plans	$2,177 - $2,903	2038%
Networks By Design-All Plans	$2,322 - $3,097	2174%
Phcs Multiplan-All Plans	$2,322 - $3,097	2174%
Interplan-All Plans	$2,380 - $3,174	2228%
Beech Street-All Plans	$2,468 - $3,290	2311%
Choice Care-All Plans	$2,468 - $3,290	2311%
Health Mgmt Network-All Plans	$2,468 - $3,290	2311%

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 $581.
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 Ukiah Valley 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.