CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Howard Memorial

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $781
Cash Discount Price: $870
vs. Medicare Baseline: 7.31x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Howard Memorial is $781. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $870. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.31x the Medicare baseline. Located in 1 Marcela Dr, Willits, CA.

Cash / Self-Pay

$870

Average discount available for prompt cash payment at this facility.

Insurance Median

$781

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: $870 (815%)

Insurance Median: $781 (731%)

Cash: $870 (815% of Medicare)

Ins. Median: $781 (731% 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 731% of the Medicare baseline (a markup of 631%). 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
Cigna	$22 - $3,287	21%
Blue Shield Mcare	$40 - $773	37%
Medicare (plans)	$40 - $781	37%
Tricare	$40 - $773	37%
UnitedHealthcare	$40 - $2,992	37%
Ah Employee Health Plan - All Plans	$44 - $2,011	41%
Healthnet - All Plans	$59 - $3,171	55%
Western Growers/Pinnacle - All Plans	$62 - $2,900	58%
Blue Shield - All Other Plans	$77 - $1,848	72%
Medi-Cal	$123 - $209	115%
Brms - All Plans	$136 - $3,287	127%
Aetna	$178 - $2,594	167%
Blue Cross Blue Shield	$754 - $905	706%
Blue Shield Epn	$1,853	1735%
First Health Ppo - All Plans	$2,320 - $3,094	2172%
Ghn Ppo - All Plans	$2,320 - $3,094	2172%

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 $870.
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 Adventist Health Howard Memorial 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.