CMS Price Transparency Data

CT scan, sinuses

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $957
Cash Discount Price: $1,931
vs. Medicare Baseline: 8.96x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at University of Iowa Health Care Medical Center Down is $957. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,931. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 8.96x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$1,931

Average discount available for prompt cash payment at this facility.

Insurance Median

$957

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: $1,931 (1808%)

Insurance Median: $957 (896%)

Cash: $1,931 (1808% of Medicare)

Ins. Median: $957 (896% 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 896% of the Medicare baseline (a markup of 796%). 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
Immergrun	$86 - $690	81%
Aetna	$100 - $1,652	94%
UnitedHealthcare	$100 - $1,191	94%
Blue Cross Blue Shield	$101 - $1,324	95%
Healthpartners	$102 - $2,344	95%
Iowa Total Care	$104 - $1,103	97%
Wellpoint (Amerigroup)	$105 - $123	98%
Medical Associates	$117 - $1,379	110%
Molina Healthcare	$117 - $1,103	110%
Oscar Health	$218 - $1,738	204%
Great River Health Systems	$242 - $1,931	227%
Quad City Community Healthcare	$260 - $2,068	243%
Sedgwick	$277 - $2,206	259%
Global Excel	$294 - $2,344	275%
Sanford Health Plan	$294 - $2,344	275%
Aplos Health Plan	$304 - $2,206	285%
Employee Benefit Systems	$304 - $2,482	285%
Sisco	$304 - $2,427	285%
Healthsmart	$311 - $2,482	291%
Hfn	$318 - $2,537	298%
Multiplan	$318 - $2,537	298%
Midlands Choice	$713 - $1,793	668%

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 $1,931.
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 University of Iowa Health Care Medical Center Down 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.