CMS Price Transparency Data

CT scan, sinuses

Facility: Greater El Monte Community Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $601
  • Cash Discount Price: $2,398
  • vs. Medicare Baseline: 5.63x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Greater El Monte Community Hospital is $601. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,398. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 5.63x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$2,398

Average discount available for prompt cash payment at this facility.

Insurance Median
$601

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: $2,398 (2245%)
Insurance Median: $601 (563%)
Cash: $2,398 (2245% of Medicare)
Ins. Median: $601 (563% 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 563% of the Medicare baseline (a markup of 463%). 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
In Custody-Ca Highway Patrol $20 19%
Blue Cross Blue Shield $39 - $1,676 37%
Care 1St Medi Cal Hmo Cap Exceptional Care $46 - $200 43%
Clinica Medica Familiar $51 - $369 48%
Bella Vista Medical Group Ipa $93 - $1,509 87%
Global Care Medical Group Ipa $93 - $1,509 87%
Veterans Administration $94 88%
Alta Med Health Services Med Grp $116 - $838 109%
Associated Hispanic Physicians $121 - $299 113%
Aids Health Foundation $123 - $132 115%
Altamed Health Network $123 - $132 115%
Avanti $123 - $161 115%
Beverly Hospital $123 - $148 115%
Brand New Day $123 - $168 115%
Emanate Health $123 - $168 115%
Health Net Foundation $123 - $2,179 115%
Healthy Way La $123 115%
La Care Health Plan $123 - $1,844 115%
Other Non Contracted Medi-Cal Hmo $123 115%
State Of California $123 115%
Apa/Aco Inc $132 124%
Blue Shield Of California $132 - $2,003 124%
Cms $132 124%
Easy Choice Health Plan $132 124%
Health Net Inc $132 - $2,374 124%
Other Non Contracted Senior Hmo $132 124%
Pacific Alliance Medical Center Reciprocal Contract $132 124%
Scan Health Plan $132 124%
UnitedHealthcare $132 - $2,878 124%
Champus Foundation $134 125%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $134 125%
Good Samaritan Medical Practice Assoc $134 - $2,012 125%
La Care Covered Direct $134 125%
Pacificare Of California $134 125%
Self-Pay $134 125%
Ahmc Reciprocity Agreement Senior/Commercial $139 - $1,006 130%
Alignment Health Plan $139 130%
Molina Healthcare $139 130%
Inter Valley Health Plan $141 132%
Molina Healthcare Of California $141 - $450 132%
San Miguel Health Plan $148 139%
Chinatown Service Center Pace $159 149%
Intercomp $161 151%
Ahmc Health Self-Insurance Epo $168 157%
Knox-Keene Act $168 157%
Preferred Health Network $170 159%
Interplan $173 - $2,515 162%
Athens Administrators $179 168%
Multiplan $179 - $2,850 168%
Other Non Contracted Work Comp $179 168%
Caloptima $181 169%
California Thoroughbred Horesmans Foundation $232 - $1,676 217%
Universal Care $250 - $1,250 234%
Hollywood Presbyterian Adv Med Mcal $299 280%
Hollywood Presbyterian Medpoint Mcal $299 280%
Central Health Plan $300 - $536 281%
In Custody Police Dept $302 - $2,179 283%
Ahmc Reciprocity Agreement $345 323%
Community Care Network $371 - $2,682 347%
Health Payors Organization $418 - $3,018 391%
Cost Containment Strategies $450 421%
Employee Health Systems Medical Group $450 421%
Commercial Non Contract $464 - $3,353 434%
Medi-Cal Sub Acute $464 - $3,353 434%
Nuclear Medicine/Whmc $464 - $3,353 434%
One Legacy $464 - $3,353 434%
Cigna $1,565 1465%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals