CMS Price Transparency Data

CT scan, sinuses

Facility: Johnson Memorial Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 70486
  • Insurance Median: $456
  • Cash Discount Price: $669
  • vs. Medicare Baseline: 4.27x Medicare
The contracted insurance negotiated median rate for a CT scan, sinuses at Johnson Memorial Hospital is $456. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $669. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.27x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$669

Average discount available for prompt cash payment at this facility.

Insurance Median
$456

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: $669 (626%)
Insurance Median: $456 (427%)
Cash: $669 (626% of Medicare)
Ins. Median: $456 (427% 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 427% of the Medicare baseline (a markup of 327%). 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.

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
Connecticut Dept Of Correction $116 109%
Aetna $123 - $299 115%
Blue Cross Blue Shield $123 - $456 115%
Medicare (plans) $123 - $129 115%
UnitedHealthcare $123 - $1,217 115%
Cca Senior Care Options $125 117%
Cigna $127 - $949 119%
Fallon Health $163 153%
Geha $179 168%
Harvard Pilgrim Healthcare $179 168%
Claimdoc $263 246%
Diversified Administrators $263 246%
Innovative Health Plan Ii $263 246%
Centivo $292 273%
1199 National Benefit Fund $299 280%
Allied Benefit Systems $299 280%
Gravie Admin Services $299 280%
Hap $299 280%
Luminare Health $299 280%
Meritain $299 280%
Nippon Life Ins $299 280%
Webtpa $299 280%
Allegiance $391 366%
Health Partners $391 366%
Magnacare $391 366%
Bcn Domestic $456 427%
Blue Benefit Administrators Of Massachusetts $456 427%
Blue Care Network $456 427%
Blue Distinction Transplant $456 427%
Blue Shield - Ca $456 427%
Blue Shield - Id (Regence) $456 427%
Blue Shield - Ny Highmark Northeastern $456 427%
Blue Shield - Ny Highmark Western $456 427%
Blue Shield - Pa (Highmark) $456 427%
Blue Shield - Wa (Regence) $456 427%
Health Choices $456 427%
Kaiser Domestic $456 427%
Pre-Employment $456 427%
Unicare $456 427%
Wc Domestic $456 427%
Wellpoint $456 427%
Connecticare $567 - $708 531%
Health New England $791 741%
Prime Health Services $974 912%
Allied National Global Care $1,010 946%
Asrm - Reliance Standard Life Insurance $1,010 946%
Christian Care Ministry $1,010 946%
Dean Health $1,010 946%
Family Life Insurance Company $1,010 946%
Ghc Scw $1,010 946%
International Benefit Administrators $1,010 946%
Lifetime Benefit Solutions $1,010 946%
Manhattan Life $1,010 946%
Medi Share $1,010 946%
Multiplan $1,010 946%
Mvp $1,010 946%
Pai $1,010 946%
Pan-American Life $1,010 946%
Paramount Hmo $1,010 946%
Phcs $1,010 946%
Trinity Health Share $1,010 946%
Health Smart $1,034 968%
United Behavioral Health Eap $1,217 1139%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals