CMS Price Transparency Data

CT scan, sinuses

Facility: Mt Sinai Hospital Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $123
Cash Discount Price: $1,057
vs. Medicare Baseline: 1.15x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Mt Sinai Hospital Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 1.15x the Medicare baseline. Located in 15Th Street at California, Chicago, IL.

Cash / Self-Pay

$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $1,057 (990%)

Insurance Median: $123 (115%)

Cash: $1,057 (990% of Medicare)

Ins. Median: $123 (115% 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
Partners In Hlth - All Plans	$54 - $1,154	51%
Blue Cross Blue Shield	$60 - $1,835	56%
Healthlink Hmo	$67 - $1,443	63%
Healthlink Ppo - All Other Plans	$67 - $1,443	63%
Compsych Ip/Op Only - All Plans	$81 - $1,732	76%
Hfn Platinum	$88 - $1,876	82%
Multiplan Primary Ntwrk/Phcs - All Other Plans	$94 - $2,020	88%
Cigna	$105 - $3,567	98%
Hfn Epo	$108 - $2,309	101%
Multiplan Complementary Ntwrk	$108 - $2,309	101%
Tricare	$109	102%
Va Healthnet - All Plans	$109	102%
Advocate Physician Prtnrs Mcr	$112	105%
Cenpatico Illinicare Dual	$112	105%
Cenpatico Illinicare Mcr - All Other Plans	$112	105%
Humana	$112 - $9,062	105%
Lawndale Christian - All Plans	$112 - $602	105%
Meridian/Harmony D-Snp - All Plans	$112	105%
Nextlevel Hlth Icp Fhp Aca - All Plans	$112	105%
UnitedHealthcare	$112 - $893	105%
Harmony Behavioral Htlh - All Plans	$115	108%
Zing Mcr Adv - All Plans	$117	110%
Molina Mcr - All Other Plans	$118	110%
Hfn Ppo - All Other Plans	$119 - $2,540	111%
Advocate Physician Prtnrs - All Other Plans	$123	115%
Ambetter / Centene	$123 - $3,030	115%
Oscar - All Plans	$148 - $3,030	139%
Aetna	$174 - $6,522	163%
Family Health Network Mcaid - All Plans	$174	163%
Molina Mcaid	$182	170%

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 $1,057.
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 Mt Sinai Hospital 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.