CMS Price Transparency Data

CT scan, sinuses

Facility: St Elizabeth Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,252
Cash Discount Price: $2,052
vs. Medicare Baseline: 21.08x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at St Elizabeth Hospital is $2,252. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,052. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.08x the Medicare baseline. Located in 1000 Lincoln St, Fort Morgan, CO.

Cash / Self-Pay

$2,052

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,252

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: $2,052 (1921%)

Insurance Median: $2,252 (2108%)

Cash: $2,052 (1921% of Medicare)

Ins. Median: $2,252 (2108% 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 2108% of the Medicare baseline (a markup of 2008%). 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
Aetna	$90 - $4,975	84%
Blue Cross Blue Shield	$90 - $1,100	84%
Cigna	$90 - $4,975	84%
Denver Health	$90 - $2,252	84%
Devoted Health	$90	84%
Humana	$90	84%
Kaiser	$90	84%
Medicare (plans)	$90	84%
UnitedHealthcare	$90 - $4,426	84%
Centura Employee Plan	$337	316%
United Colorado Doctor'S Plan	$3,985	3731%
Direct To Employer	$4,206	3938%
Multiplan	$4,821 - $4,975	4514%

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 $2,052.
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 St Elizabeth 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.