CMS Price Transparency Data

CT scan, sinuses

Facility: Memorial Hospital, The

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,231
Cash Discount Price: $940
vs. Medicare Baseline: 11.53x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Memorial Hospital, The is $1,231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $940. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 11.53x the Medicare baseline. Located in 750 Hospital Loop, Craig, CO.

Cash / Self-Pay

$940

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,231

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: $940 (880%)

Insurance Median: $1,231 (1153%)

Cash: $940 (880% of Medicare)

Ins. Median: $1,231 (1153% 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 1153% of the Medicare baseline (a markup of 1053%). 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	$535 - $1,447	501%
Care Advantage	$535 - $1,447	501%
Cvs Caremark-Part D	$535 - $1,447	501%
Denver Health	$535 - $1,447	501%
Humana	$535 - $1,447	501%
Kaiser	$535 - $1,447	501%
Rmhp Dualcare	$535 - $1,447	501%
Blue Cross Blue Shield	$837 - $1,447	784%
Golden Rule Ins	$1,230	1152%
UnitedHealthcare	$1,230 - $1,447	1152%
Allegiance	$1,231	1153%
Cigna	$1,231	1153%
Geha	$1,231	1153%
Great West Hlthcare	$1,231	1153%
Health Partners	$1,231	1153%
Multiplan Inc Ppo	$1,331 - $1,374	1246%
First Health Other	$1,374	1286%

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 $940.
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 Memorial Hospital, The 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.