CMS Price Transparency Data

CT scan, sinuses

Facility: Southwest Healthcare Rancho Springs Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,498
Cash Discount Price: $1,759
vs. Medicare Baseline: 14.02x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Southwest Healthcare Rancho Springs Hospital is $1,498. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,759. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 14.02x the Medicare baseline. Located in 25500 Medical Center Drive, Murrieta, CA.

Cash / Self-Pay

$1,759

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,498

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: $1,759 (1647%)

Insurance Median: $1,498 (1402%)

Cash: $1,759 (1647% of Medicare)

Ins. Median: $1,498 (1402% 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 1402% of the Medicare baseline (a markup of 1302%). 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
Health_Net	$92 - $1,725	86%
Kaiser	$106 - $1,498	99%
United_Healthcare	$126 - $178	118%
Heritage	$137 - $1,930	128%
Iehp	$162	152%
Blue Cross Blue Shield	$329 - $2,474	308%
Aetna	$1,049	982%
Cigna	$1,347 - $1,810	1261%
Primecare	$1,495 - $2,010	1400%
Palomar	$1,763 - $2,370	1651%
Rady_Children'S_Hospital	$2,626 - $3,530	2459%
Multiplan	$3,376 - $4,539	3161%
Sharp_Health_Plan	$3,376 - $4,539	3161%

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 $1,759.
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 Southwest Healthcare Rancho Springs 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.