CMS Price Transparency Data

CT scan, sinuses

Facility: St Luke's McCall

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $788
Cash Discount Price: $1,090
vs. Medicare Baseline: 7.38x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at St Luke's McCall is $788. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,090. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 7.38x the Medicare baseline. Located in 1000 State Street, McCall, ID.

Cash / Self-Pay

$1,090

Average discount available for prompt cash payment at this facility.

Insurance Median

$788

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: $1,090 (1021%)

Insurance Median: $788 (738%)

Cash: $1,090 (1021% of Medicare)

Ins. Median: $788 (738% 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 738% of the Medicare baseline (a markup of 638%). 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
Commercial [1028]	$475 - $1,307	445%
Medicare (plans)	$475 - $805	445%
Veterans Affairs [1056]	$475 - $789	445%
Blue Cross Blue Shield	$480 - $1,198	449%
Aetna	$523 - $1,293	490%
Moda [1055]	$721 - $1,198	675%
Cigna	$762 - $1,266	713%
Providence [1022]	$762 - $1,266	713%
Pacificsource [1020]	$770 - $1,279	721%
First Health [1064]	$778 - $1,293	728%
Webtpa [1071]	$778 - $1,293	728%
Geha [1065]	$786 - $1,307	736%
United Medical Resources [1051]	$786 - $1,307	736%
UnitedHealthcare	$786 - $1,307	736%

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 $1,090.
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 St Luke's McCall 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.