CMS Price Transparency Data

CT scan, sinuses

Facility: West Valley Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,698
Cash Discount Price: $2,844
vs. Medicare Baseline: 15.90x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at West Valley Medical Center is $1,698. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,844. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 15.90x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$2,844

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,698

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: $2,844 (2663%)

Insurance Median: $1,698 (1590%)

Cash: $2,844 (2663% of Medicare)

Ins. Median: $1,698 (1590% 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 1590% of the Medicare baseline (a markup of 1490%). 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
Blue Cross Blue Shield	$32 - $2,702	30%
Molina	$32 - $68	30%
Regence	$219	205%
United	$245 - $1,698	229%
Select Health Idaho (Eirmc Only)	$907	849%
Corizon Health	$1,052	985%
True Blue	$1,123	1051%
Cigna	$1,593	1491%
Pacificsource Health	$1,698	1590%
Moda	$1,772	1659%
St Luke'S Health Partners	$1,849	1731%
Aetna	$2,250	2107%
Four Rivers Hospice	$2,275	2130%
Multiplan	$2,275	2130%
Humana	$2,389	2237%
Geha Ppo Usa	$2,417	2263%
Coventry First Health	$2,560	2397%
St Alphonsus Health	$2,560	2397%

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 $2,844.
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 West Valley 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.