CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Sonora

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $160
  • Cash Discount Price: $383
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Sonora is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.50x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$383

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: $383 (359%)
Insurance Median: $160 (150%)
Cash: $383 (359% 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
Blue Shield Mcare $40 - $144 37%
Central Ca Alliance Mcr Adv Profee Only $40 37%
Healthnet Mcr Adv $40 - $144 37%
Tricare $40 - $144 37%
UnitedHealthcare $40 - $3,734 37%
Ah Employee Health Plan - All Plans $44 - $259 41%
Cigna $50 - $4,126 47%
Greatwest Oa/Pos/Hmo $53 - $3,692 50%
Greatwest Ppo - All Other Plans $53 - $3,909 50%
Healthnet - All Other Plans $59 - $3,804 55%
Western Growers/Pinnacle - All Plans $60 - $2,302 56%
Blue Shield Epn $73 - $3,292 68%
Blue Shield - All Other Plans $77 - $3,301 72%
Bc Mcal $123 115%
Celtic Ca Hlth Well Mcal - All Plans $123 - $288 115%
Central Ca Alliance Mcal $123 - $236 115%
Healthnet Mcal $123 - $311 115%
Medi-Cal $123 - $209 115%
Aetna $144 - $3,885 135%
Beech Street- All Plans $144 - $3,692 135%
Phs Prime Health Srvcs-All Plans $144 135%
Trpn - Three Rivers Ppo - All Plans $144 - $3,474 135%
Central Ca Alliance Ccs Mcal $160 - $236 150%
Central Ca Alliance Chdp Mcal $160 - $236 150%
Central Ca Alliance Comm Profee Only-All Other Pla $160 150%
Bc Exchange $679 636%
Bc Non-Mcs - All Other Plans $754 706%
Bc Mcs $905 847%
Kaiser - All Plans $2,172 2034%
Affordable Health - All Plans $3,909 3660%
Interplan - All Plans $3,909 3660%
Multiplan - All Plans $3,909 3660%
Phcs Ppo - All Plans $3,909 3660%
Stanilaus Foundation - All Plans $4,126 3863%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals