CMS Price Transparency Data

CT scan, sinuses

Facility: Atrium Health Navicent Peach

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $285
Cash Discount Price: $678
vs. Medicare Baseline: 2.67x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Atrium Health Navicent Peach is $285. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $678. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 2.67x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$678

Average discount available for prompt cash payment at this facility.

Insurance Median

$285

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: $678 (635%)

Insurance Median: $285 (267%)

Cash: $678 (635% of Medicare)

Ins. Median: $285 (267% 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 267% of the Medicare baseline (a markup of 167%). 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	$44 - $800	41%
Blue Cross Blue Shield	$44 - $285	41%
Georgia Health Advantage	$44 - $285	41%
Humana	$44 - $1,153	41%
UnitedHealthcare	$44 - $854	41%
Care Source	$45 - $290	42%
Clover	$45 - $290	42%
Eon Health	$45 - $290	42%
Alliant	$46 - $664	43%
Pruitt Health	$46 - $285	43%
Ambetter / Centene	$50 - $692	47%
Cigna	$119 - $987	111%
Securehealth	$133 - $881	125%
Multiplan	$881 - $1,085	825%
Novanet	$1,085	1016%
Three Rivers Provider Network	$1,153	1079%
Beechstreet	$1,261	1181%

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 $678.
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 Atrium Health Navicent Peach 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.