CMS Price Transparency Data

CT scan, sinuses

Facility: Los Robles Hospital & Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,027
Cash Discount Price: $3,473
vs. Medicare Baseline: 18.98x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Los Robles Hospital & Medical Center is $2,027. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,473. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 18.98x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$3,473

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,027

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: $3,473 (3252%)

Insurance Median: $2,027 (1898%)

Cash: $3,473 (3252% of Medicare)

Ins. Median: $2,027 (1898% 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 1898% of the Medicare baseline (a markup of 1798%). 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
Brand New Day	$138	129%
Gold Coast Health Plan	$138	129%
Blue Cross Blue Shield	$199 - $699	186%
United	$245 - $1,240	229%
Medcare Partners	$380 - $662	356%
Aetna	$1,263 - $4,411	1182%
First Health	$1,723 - $3,529	1613%
Choicecare Network	$1,774 - $3,088	1661%
Multiplan	$2,027 - $4,191	1898%
Ppo Next	$2,027 - $3,529	1898%
Interplan Corporation	$2,280 - $3,970	2135%
Ventura County Foundation	$2,280 - $3,970	2135%
Blue Shield	$2,333 - $3,334	2184%

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 $3,473.
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 Los Robles Hospital & Medical Center 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.