CMS Price Transparency Data

CT scan, sinuses

Facility: Lost Rivers Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,033
Cash Discount Price: $1,280
vs. Medicare Baseline: 9.67x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Lost Rivers Medical Center is $1,033. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,280. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 9.67x the Medicare baseline. Located in 551 Highland Drive, Arco, ID.

Cash / Self-Pay

$1,280

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,033

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: $1,280 (1198%)

Insurance Median: $1,033 (967%)

Cash: $1,280 (1198% of Medicare)

Ins. Median: $1,033 (967% 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 967% of the Medicare baseline (a markup of 867%). 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
Provider Network Of America-All Plans	$192	180%
Select Health Brightpath-All Other Plans	$907	849%
Tricare	$907	849%
Ihcn Brightpath-All Other Plans	$958	897%
Va Pccc-All Plans	$978	916%
Blue Cross Blue Shield	$1,008 - $1,600	944%
Humana	$1,008 - $1,600	944%
Ihcn Brightpath Mcr Adv	$1,008	944%
Molina Mcr Adv-All Plans	$1,008	944%
Pacificsource Mcr Adv	$1,008	944%
Regence/Brightpth Slhp Mcr	$1,008	944%
Select Health Mcr Adv	$1,008	944%
Prime Hlth Mcr Adv	$1,058	991%
Aetna	$1,088 - $1,504	1019%
Cigna	$1,488	1393%
First Choice-All Plans	$1,488	1393%
Pacificsource Navigator-All Other Plans	$1,520	1423%
UnitedHealthcare	$1,520	1423%
Altius Health Plan-All Plans	$1,552	1453%
Regence Blue Shield-All Other Plans	$5,888	5513%

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 $1,280.
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 Lost Rivers 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.