CMS Price Transparency Data

CT scan, sinuses

Facility: Pali Momi Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $156
Cash Discount Price: $1,047
vs. Medicare Baseline: 1.46x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Pali Momi Medical Center is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,047. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.46x the Medicare baseline. Located in 98-1079 Moanalua Road, Aiea, HI.

Cash / Self-Pay

$1,047

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $1,047 (980%)

Insurance Median: $156 (146%)

Cash: $1,047 (980% of Medicare)

Ins. Median: $156 (146% 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.

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
Alohacare	$90 - $139	84%
Ohana	$93 - $151	87%
Hmsa	$126 - $311	118%
Mdx	$126 - $135	118%
Devoted	$132	124%
UnitedHealthcare	$156	146%
Hwmg/Hmaa	$235	220%
Pac Admin	$374	350%
Uha	$408	382%
Verdegard	$410	384%
Calvos	$1,309	1226%
Mimoh	$1,309	1226%
Hcha	$1,396	1307%
Kaiser	$1,396	1307%
Multiplan	$1,396 - $1,483	1307%
Coventry	$1,483	1388%
Mccp	$1,483	1388%

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 $1,047.
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 Pali Momi 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.