CMS Price Transparency Data

CT scan, sinuses

Facility: Community Memorial Hospital - Ventura

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $187
Cash Discount Price: $335
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Community Memorial Hospital - Ventura is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.75x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$335

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $335 (314%)

Insurance Median: $187 (175%)

Cash: $335 (314% of Medicare)

Ins. Median: $187 (175% 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.

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
Seaview	$108	101%
Valley Care	$112 - $187	105%
Tricare	$128	120%
Aetna	$135 - $1,715	126%
Blue Cross Blue Shield	$135 - $411	126%
California Workers Compensation	$135	126%
Medicare (plans)	$135 - $138	126%
Non Contracted	$135 - $299	126%
Wellcare Of California	$135	126%
Alignment Health Plan	$138	129%
Humana	$138	129%
Scan Health Plan	$138	129%
UnitedHealthcare	$138 - $236	129%
Ventura County Health Care Plan	$140	131%
Gold Coast Health Plan	$195 - $448	183%
Medicaid / KanCare	$195 - $438	183%
Cigna	$275	257%
Medi-Cal	$299	280%
Multiplan	$335	314%
Health Net Commercial	$493	462%
Kaiser Commercial	$848	794%
Blue Shield Epn	$928	869%
Blue Shield Commercial	$1,041	975%

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 $335.
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 Community Memorial Hospital - Ventura 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.