CMS Price Transparency Data

CT scan, sinuses

Facility: Methodist Jennie Edmundson

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $667
Cash Discount Price: $518
vs. Medicare Baseline: 6.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Methodist Jennie Edmundson is $667. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $518. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 6.24x the Medicare baseline. Located in 933 East Pierce Street, Council Bluffs, IA.

Cash / Self-Pay

$518

Average discount available for prompt cash payment at this facility.

Insurance Median

$667

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: $518 (485%)

Insurance Median: $667 (624%)

Cash: $518 (485% of Medicare)

Ins. Median: $667 (624% 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 624% of the Medicare baseline (a markup of 524%). 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	$105 - $1,075	98%
Humana	$105	98%
Medicare (plans)	$105 - $896	98%
Blue Cross Blue Shield	$107 - $1,165	100%
Medica	$107 - $951	100%
UnitedHealthcare	$107 - $1,075	100%
Elite Choice - Mje	$218 - $227	204%
Ambetter / Centene	$221 - $247	207%
Wellmark	$260 - $286	243%
Midlands Choice	$306 - $1,254	286%
Ne Furniture Mart	$511 - $1,075	478%
Medica Choice	$556 - $1,119	521%

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 $518.
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 Methodist Jennie Edmundson 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.