CMS Price Transparency Data

CT scan, sinuses

Facility: Mayers Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,119
Cash Discount Price: $1,432
vs. Medicare Baseline: 10.48x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Mayers Memorial Hospital is $1,119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,432. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 10.48x the Medicare baseline. Located in 43563 Hwy 299 East, Fall River Mills, CA.

Cash / Self-Pay

$1,432

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,119

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: $1,432 (1341%)

Insurance Median: $1,119 (1048%)

Cash: $1,432 (1341% of Medicare)

Ins. Median: $1,119 (1048% 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 1048% of the Medicare baseline (a markup of 948%). 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
Blue Shield Ca Va	$38 - $956	36%
Blue Shield Mcr Adv	$38 - $956	36%
Tricare	$38 - $1,006	36%
Health Net Mcr Adv	$40 - $1,006	37%
Arcadian Health Services-All Plans	$42 - $1,006	39%
Imperial Health Plan-All Plans	$46 - $1,137	43%
Medi-Cal	$123 - $209	115%
Cigna	$165 - $1,448	154%
Corvel Ppo-All Plans	$165 - $1,448	154%
Coventry/First Health-All Plans	$165 - $1,448	154%
Integrated Hp-All Plans	$165 - $1,448	154%
Interplan-All Plans	$165 - $1,448	154%
Partnership Hp-All Plans	$835	782%
Blue Cross Blue Shield	$954 - $1,303	893%
Health Net Prison	$1,030 - $1,096	964%
Blue Shield Ca Exchange	$1,224 - $1,303	1146%
Blue Shield-All Other Plans	$1,360 - $1,448	1273%
Hmn-All Plans	$1,360 - $1,448	1273%
Multiplan Phcs-All Plans	$1,360 - $1,448	1273%
Pfmc-All Plans	$1,360 - $1,448	1273%
Superior Ca-All Plans	$1,360 - $1,448	1273%
Health Net-All Other Plans	$1,425 - $1,516	1334%
Pacificare-All Plans	$1,432 - $1,524	1341%

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 $1,432.
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 Mayers Memorial 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.