CMS Price Transparency Data

CT scan, sinuses

Facility: Menifee Global Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $365
  • Cash Discount Price: $1,941
  • vs. Medicare Baseline: 3.42x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Menifee Global Medical Center is $365. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,941. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 3.42x the Medicare baseline. Located in 28400 McCall Boulevard, Sun City, CA.
Cash / Self-Pay
$1,941

Average discount available for prompt cash payment at this facility.

Insurance Median
$365

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: $1,941 (1817%)
Insurance Median: $365 (342%)
Cash: $1,941 (1817% of Medicare)
Ins. Median: $365 (342% 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 342% of the Medicare baseline (a markup of 242%). 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
Tricare $117 - $125 110%
Aetna $134 - $1,193 125%
Altamed Comm Hmo (Ancillary) $134 - $2,184 125%
Altamed Health Services Senior $134 125%
Altamed Sr/Pace $134 125%
Blue Shield Senior $134 125%
Central Health Plan Senior $134 125%
Clever Care Health Plan Sr $134 125%
For Your Benefit Senior $134 125%
Guidant Health Plan Senior $134 125%
Health Net Senior $134 125%
Hpn Senior $134 125%
Humana $134 125%
Ic $134 - $2,184 125%
Imperial Health Plan Of Ca $134 125%
Kaiser Senior $134 125%
Lasalle Medical Assoc (Ancillary) Commercial $134 125%
Lasalle Medical Assoc (Ancillary) Senior $134 125%
Managed Health Network Sr $134 125%
Medicare (plans) $134 125%
Neighborhood Healthcare Pace $134 125%
Point Comfort Underwriters $134 125%
Primecare Senior $134 125%
Prospect Health Plan Sr Hmo $134 125%
Scan Senior $134 125%
Self Pay/Ab774/Charity Discount $134 125%
Sr Capitation $134 125%
UnitedHealthcare $134 - $174 125%
Veterans Administration $134 125%
Lasalle Medical Assoc (Ancillary) Mcal Hmo $146 137%
Align Senior Care $150 140%
Welbehealth Sr/Pace $150 140%
Prime Health Services Senior $154 144%
Molina Covered Ca $159 149%
Coventry $161 - $167 151%
Prime Health Services Wcomp $161 151%
Iehp Covered Ca $167 156%
Three Rivers Wcomp $175 164%
Workers Comp Non-Contracted $179 168%
Prospect Health Plan Comm Hmo $181 169%
Health Net Enhanced Ppo $187 - $193 175%
Hpn Commercial/Covered Ca $187 175%
Cigna $189 - $1,747 177%
Health Net Comm $201 188%
Three Rivers Network $235 220%
Velocity $235 - $983 220%
Health Net Medi-Cal $299 280%
Hpn Mcal $299 280%
Kaiser Medi-Cal $299 280%
Prospect Health Plan Mcal Hmo $308 288%
Blue Cross Blue Shield $314 294%
Molina Medi-Cal $353 330%
Blue Shield Epn $376 352%
Altamed Mcal Hmo $419 392%
Altamed Mcal/Pace $419 392%
Choice Physicians Network $419 392%
Blue Shield Commercial $443 415%
Iehp Medi-Cal $449 420%
Primecare Commercial $635 595%
First Health Commercial $891 - $1,147 834%
Multiplan Ppo $1,188 - $1,529 1112%
Multiplan Wcomp $1,188 - $1,529 1112%
Pnoa-Provider Network Of America $1,358 - $1,747 1271%
Prime Health Services Commercial $1,358 - $1,747 1271%
Ava Hospice $1,697 - $2,184 1589%
Kaiser Commercial $1,697 - $2,184 1589%
Living Waters Hospice $1,697 - $2,184 1589%
Managed Health Network $1,697 - $2,184 1589%
Other Insurance Loa $1,697 - $2,184 1589%
Pacific Valley Hospice $1,697 - $2,184 1589%
Private Pay $1,697 - $2,184 1589%
Silverado Hospice $1,697 - $2,184 1589%
Vna Hospice $1,697 - $2,184 1589%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 28400 McCall Boulevard, Sun City, CA 92585
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals