CMS Price Transparency Data

CT scan, sinuses

Facility: Connecticut Childrens Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $502
Cash Discount Price: $399
vs. Medicare Baseline: 4.70x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Connecticut Childrens Medical Center is $502. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $399. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 4.70x the Medicare baseline. Located in 282 Washington Street, Hartford, CT.

Cash / Self-Pay

$399

Average discount available for prompt cash payment at this facility.

Insurance Median

$502

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: $399 (374%)

Insurance Median: $502 (470%)

Cash: $399 (374% of Medicare)

Ins. Median: $502 (470% 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 470% of the Medicare baseline (a markup of 370%). 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
Golden Rule [100106]	$168 - $559	157%
Harvard Pilgrim [1001134]	$168 - $559	157%
Oxford [100103]	$168 - $559	157%
UnitedHealthcare	$168 - $563	157%
Aetna	$317 - $559	297%
1199 National Benefit Fund [100134]	$351 - $559	329%
Government Employees Hospital Assoc [100115]	$351 - $559	329%
Humana	$351 - $559	329%
Meritain Health [100149]	$351 - $559	329%
Nippon Life Ins Co Of America [100112]	$351 - $559	329%
Yale Health Plan [100162]	$351 - $559	329%
Connecticare [100105]	$359 - $563	336%
Emblem Health Commercial [1001108]	$359 - $563	336%
Medicaid / KanCare	$359 - $563	336%
Blue Cross Blue Shield	$409 - $502	383%
Unicare [100148]	$409 - $502	383%
Wellpoint [100150]	$409 - $502	383%
Multiplan [1001126]	$485 - $565	454%
Cdphp/Comm [100199]	$565	529%
Generic Multiplan [1001130]	$565	529%
Ultrabenefits/Comm [100181]	$565	529%

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 $399.
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 Connecticut Childrens 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.