CMS Price Transparency Data

CT scan, sinuses

Facility: Southeast Iowa Regional Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $97
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Southeast Iowa Regional Medical Center is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 1221 South Gear Avenue, West Burlington, IA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$97

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%)

Insurance Median: $97 (91%)

Ins. Median: $97 (91% 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
American Healthplan Of Iowa - Midlevel	$31	29%
Humana	$39	37%
Aetna	$40	37%
American Healthplan Of Iowa - Md	$42	39%
Medicaid / KanCare	$47 - $55	44%
Plain Church	$70 - $1,292	66%
Blue Cross Blue Shield	$78 - $366	73%
UnitedHealthcare	$79	74%
Midlands Choice	$86 - $1,789	81%
Absolute Solutions	$97	91%
First Agency	$97	91%
Multiplan	$97	91%
Henderson County	$103	96%
Wellpoint (Amerigroup)	$1,113	1042%
Immugrun	$1,252	1172%
Brighton Amish Church	$1,292	1210%
6 Degree	$1,590	1489%
Geha	$1,849	1731%

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 $X.
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 Southeast Iowa Regional 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.