CMS Price Transparency Data

CT scan, sinuses

Facility: Doctors Hospital

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $256
Cash Discount Price: $3,217
vs. Medicare Baseline: 2.40x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Doctors Hospital is $256. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,217. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.40x the Medicare baseline. Located in 3651 Wheeler Road, Augusta, GA.

Cash / Self-Pay

$3,217

Average discount available for prompt cash payment at this facility.

Insurance Median

$256

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: $3,217 (3012%)

Insurance Median: $256 (240%)

Cash: $3,217 (3012% of Medicare)

Ins. Median: $256 (240% 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 240% of the Medicare baseline (a markup of 140%). 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
Blue Cross Blue Shield	$58 - $256	54%
Ambetter / Centene	$142	133%
Health One Alliance	$147	138%
Aetna	$217 - $1,774	203%
United	$245 - $1,448	229%
Prime Health	$267	250%
Rockport United Network	$273	256%
Identity Mco	$279	261%
Blue Choice	$306	286%
Amerigroup	$457	428%
Absolute Total Care	$579	542%
Nhc Advantage	$611	572%
Pruitt Health	$611	572%
Peach State	$643	602%
Wellcare	$643	602%
Americas 1St Choice	$901	844%
Medcost	$1,612 - $2,056	1509%
Multiplan	$1,930 - $2,896	1807%
Performax	$2,188	2048%
First Health	$2,413	2259%
Employer'S Health Network	$2,574	2410%
Novanet	$2,896	2711%

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 $3,217.
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 Doctors 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.