CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Tulare

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $179
  • Cash Discount Price: $451
  • vs. Medicare Baseline: 1.68x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Tulare is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.68x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.
Cash / Self-Pay
$451

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $451 (422%)
Insurance Median: $179 (168%)
Cash: $451 (422% of Medicare)
Ins. Median: $179 (168% 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.

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
Cigna $22 - $1,465 21%
Blue Shield Mcare $40 - $134 37%
Fhcn Pace Mcr Adv - All Plans $40 - $134 37%
Medicare (plans) $40 - $134 37%
Tricare $40 - $134 37%
UnitedHealthcare $40 - $2,292 37%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot $40 37%
Ah Employee Health Plan - All Plans $44 - $242 41%
Incentive Hlth - All Plans $44 - $242 41%
Hs Interplan-All Plans $51 - $2,120 48%
Cal Forensic Med Grp - All Plans $53 - $175 50%
Healthnet Hmo/Ppo - All Other Plans $59 - $358 55%
Blue Shield Epn $73 - $1,000 68%
Blue Shield-All Other Plans $77 - $1,383 72%
Blue Cross Blue Shield $87 - $983 81%
Ccipa Medi-Cal - All Plans $123 - $271 115%
Healthnet Medi-Cal $123 - $273 115%
Medi-Cal $123 - $209 115%
Upn-United Physcn Ntwrk Mcal Profee Only $123 115%
Dignity Mcr Op Only - All Other Plans $134 125%
Prime Health - All Plans $134 125%
Prison Hlthcre - All Plans $172 161%
Aetna $178 - $1,105 167%
Bright Health - All Plans $195 183%
Dignity Mcal Op Only $230 215%
Independence Op Only - All Plans $230 215%
Western Growers - All Plans $1,092 - $1,455 1022%
Network By Design-All Plans $1,661 - $2,215 1555%
Multiplan - All Plans $2,017 - $2,689 1888%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 869 North Cherry Street, Tulare, CA 93274
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals