CMS Price Transparency Data

CT scan, sinuses

Facility: Adventist Health Vallejo

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,162
Cash Discount Price: $666
vs. Medicare Baseline: 20.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Adventist Health Vallejo is $2,162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $666. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.24x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$666

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,162

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: $666 (624%)

Insurance Median: $2,162 (2024%)

Cash: $666 (624% of Medicare)

Ins. Median: $2,162 (2024% 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 2024% of the Medicare baseline (a markup of 1924%). 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 - $4,970	21%
Blue Shield Mcr Adv	$40 - $106	37%
Medicare (plans)	$40 - $106	37%
Napa County Mcal Child	$40 - $106	37%
Tricare	$40 - $106	37%
Ah Employee Health Plan-All Plans	$44 - $191	41%
Interplan-All Plans	$48 - $4,038	45%
Kaiser-All Plans	$48 - $5,218	45%
Blue Shield Non-Epn-All Other Plans	$51 - $2,882	48%
UnitedHealthcare	$53 - $3,960	50%
Western Growers-All Plans	$59 - $3,292	55%
Aetna	$76 - $1,270	71%
Phcs-All Plans	$97 - $3,417	91%
Va Mcr-All Other Plans	$106	99%
Medi-Cal	$123 - $209	115%
Health Management Network-All Plans	$150 - $5,280	140%
Three Rivers-All Plans	$159 - $5,591	149%
Va Medi-Cal	$209	196%
Blue Cross Blue Shield	$805 - $966	754%
Healthnet-All Plans	$1,060	992%
Blue Shield Behav Hlth	$1,498 - $2,795	1402%
Blue Shield Epn	$1,567 - $2,926	1467%
Choicecare-All Plans	$2,330 - $4,348	2181%
Beech Street-All Plans	$2,496 - $4,659	2337%
Galaxy Network-All Plans	$2,995 - $5,591	2804%

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 $666.
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 Vallejo 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.