CMS Price Transparency Data

CT scan, sinuses

Facility: Memorialcare Saddleback Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $254
  • Cash Discount Price: $4,325
  • vs. Medicare Baseline: 2.38x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Memorialcare Saddleback Medical Center is $254. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,325. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.38x the Medicare baseline. Located in 24451 Health Center Drive, Laguna Hills, CA.
Cash / Self-Pay
$4,325

Average discount available for prompt cash payment at this facility.

Insurance Median
$254

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: $4,325 (4049%)
Insurance Median: $254 (238%)
Cash: $4,325 (4049% of Medicare)
Ins. Median: $254 (238% 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 238% of the Medicare baseline (a markup of 138%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Select Health $87 - $182 81%
Seoul Medical Group $121 113%
Blue Shield $132 - $2,288 124%
Aetna $134 125%
UnitedHealthcare $134 125%
Blue Cross Blue Shield $141 - $489 132%
Easy Choice $141 132%
Central Health $148 139%
Clever Care $161 151%
Monarch Health Plan $168 - $336 157%
Centivo $303 284%
Cigna $307 - $446 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 24451 Health Center Drive, Laguna Hills, CA 92653
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals