CMS Price Transparency Data

CT scan, sinuses

Facility: Lutheran Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $886
Cash Discount Price: Unavailable
vs. Medicare Baseline: 8.30x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Lutheran Medical Center is $886. 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 8.30x the Medicare baseline. Located in 8300 W 38Th Ave, Wheat Ridge, CO.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$886

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: $886 (830%)

Ins. Median: $886 (830% 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 830% of the Medicare baseline (a markup of 730%). 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
Aarp	$106	99%
UnitedHealthcare	$106 - $1,052	99%
Kaiser Snp	$107	100%
Select Health	$107	100%
Denv Hlth Med Plan	$278	260%
Aetna	$309 - $1,627	289%
Kaiser Perm Hmo	$335 - $764	314%
Geha	$337 - $1,052	316%
Preferred One	$337 - $724	316%
Kaiser Self Funded	$417 - $764	390%
Kaiser Perm Ppo/Pos	$423 - $787	396%
Allegiance	$453	424%
Cigna	$453 - $1,813	424%
Blue Cross Blue Shield	$722 - $1,524	676%
Humana	$762	713%
Cofinity	$1,307	1224%
First Health Network	$1,307	1224%
Private Hlthcare Sys	$1,360	1273%
Multiplan Inc	$1,523	1426%

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 $X.
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 Lutheran Medical Center 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.