CMS Price Transparency Data

CT scan, sinuses

Facility: Valley Children's Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $1,734
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 16.23x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Valley Children's Hospital is $1,734. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.23x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,734

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%)
Insurance Median: $1,734 (1623%)
Ins. Median: $1,734 (1623% 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 1623% of the Medicare baseline (a markup of 1523%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Allcare Ipa $299 280%
Kaiser $303 - $2,147 284%
UnitedHealthcare $331 - $844 310%
Dignity Ipa_Formerly Img $419 392%
La Salle Ipa $419 392%
Sante Ipa $419 392%
Central Valley Medical Providers Ipa $449 - $1,652 420%
Sequoia Health Ipa $449 420%
Univseral Healthcare Ipa $449 420%
United Physicians Network Ipa $464 434%
Community Care Ipa $473 443%
Adventist $528 494%
Blue Cross Blue Shield $542 - $2,360 507%
Cencal Health $592 554%
Kern Family Health Care $598 560%
Central California Alliance For Health $609 570%
Health Net $1,162 - $2,163 1088%
Dignity Health Central Coast $1,637 1533%
Community Health $1,817 1701%
Stanislaus Partners In Health $1,817 1701%
Physicians Choice Medical Group $1,850 1732%
Health Plan Of San Joaquin $1,982 1856%
Fowler Packing $2,048 1917%
Dignity (Formerly Managed Care Systems) $2,081 1948%
Kern Legacy $2,147 2010%
Blue Shield $2,206 - $2,506 2065%
Aetna $2,213 2072%
First Health Formerly Coventry $2,444 2288%
Bakersfield Family Medical Group $2,477 2319%
Network By Design $2,560 2397%
Community Care Health Plan $2,641 2473%
Health Smart $2,642 2474%
Key Medical Ipa $2,642 2474%
Sutter Health $2,808 2629%
Multiplan $3,160 2959%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens