CMS Price Transparency Data

CT scan, sinuses

Facility: Stanford Health Care

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $193
Cash Discount Price: $609
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Stanford Health Care is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $609. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.81x the Medicare baseline. Located in 300 Pasteur Drive, Stanford, CA.

Cash / Self-Pay

$609

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $609 (570%)

Insurance Median: $193 (181%)

Cash: $609 (570% of Medicare)

Ins. Median: $193 (181% 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
Health Plan Of San Mateo [31200]	$63 - $216	59%
Beech St [10600]	$101 - $376	95%
Claritev [13400]	$101 - $376	95%
Kaiser Northern Ca [12900]	$101 - $376	95%
Private Healthcare Systems (Phcs) [14200]	$101 - $376	95%
Healthnet Alt Payer [912100000]	$102 - $382	95%
Healthnet [12100]	$102 - $382	95%
Cigna	$110 - $795	103%
Healthnet	$154	144%
UnitedHealthcare	$169 - $618	158%
Aetna	$180 - $893	169%
Blue Card (Out Of State) [40000]	$181 - $1,231	169%
Blue Cross Blue Shield	$181 - $1,231	169%
Shca Comm Intel [20300000]	$181 - $1,231	169%
American Specialty Health Plan Alt Payer [971000000]	$193 - $755	181%
Blue Card (Out Of State) - Blue Shield [40200]	$193 - $755	181%
Blue Shield Alt Payer [970000000]	$193 - $755	181%
Blue Shield [70000]	$193 - $755	181%
Psych Blue Shield Alt Payer [970000100]	$193 - $755	181%

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 $609.
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 Stanford Health Care 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.