CMS Price Transparency Data

CT scan, sinuses

Facility: UCSF Health St. Mary's Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $177
Cash Discount Price: $5,105
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at UCSF Health St. Mary's Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,105. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.66x the Medicare baseline. Located in 450 Stanyan St, San Francisco, CA.

Cash / Self-Pay

$5,105

Average discount available for prompt cash payment at this facility.

Insurance Median

$177

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: $5,105 (4780%)

Insurance Median: $177 (166%)

Cash: $5,105 (4780% of Medicare)

Ins. Median: $177 (166% 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
Aetna	$156 - $1,507	146%
Blue Cross Blue Shield	$156 - $5,872	146%
Blue Shield Ca	$156	146%
Brown Toland	$156 - $178	146%
Chinese Community	$156 - $3,318	146%
Connected Care	$156	146%
Health Net	$156 - $259	146%
Health Plan San Mateo	$156 - $177	146%
Humana	$156	146%
Kaiser	$156 - $3,880	146%
Mhn	$156	146%
United	$156 - $245	146%
Sfhp	$173	162%
California Health & Wellness	$177	166%
Partnership Health Plan	$177	166%
Kentfield	$453	424%
Oscar	$512	479%
Magellan	$3,063	2868%
Cigna	$3,119 - $3,318	2920%
Healthsmart	$3,574	3346%
Multiplan	$4,237	3967%
Us Behavioral Health	$5,105	4780%

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 $5,105.
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 UCSF Health St. Mary's Hospital 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.