CMS Price Transparency Data

CT scan, sinuses

Facility: Memorial Medical Center

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,168
Cash Discount Price: $3,613
vs. Medicare Baseline: 20.30x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Memorial Medical Center is $2,168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,613. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 20.30x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$3,613

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,168

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: $3,613 (3383%)

Insurance Median: $2,168 (2030%)

Cash: $3,613 (3383% of Medicare)

Ins. Median: $2,168 (2030% 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 2030% of the Medicare baseline (a markup of 1930%). 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
Veterans Administration	$79	74%
Blue Cross Blue Shield	$103 - $3,613	96%
Aetna	$110 - $2,746	103%
Health Alliance	$110 - $2,348	103%
Medicare (plans)	$110 - $3,613	103%
Tricare	$110	103%
UnitedHealthcare	$110 - $2,240	103%
Humana	$116 - $2,168	109%
Medicaid / KanCare	$134	125%
Molina	$137	128%
Healthlink	$447 - $2,276	419%
Cigna	$1,041	975%
Commercial Workers Compensation	$1,155	1081%
Illinois Workers Compensation	$1,216	1138%
Current Health Network Ppo	$1,626	1522%
Phcs/Multiplan	$1,951 - $2,168	1827%
6 Degrees Health	$2,168	2030%
Hopetrust	$2,168	2030%
Hst	$2,168	2030%
Magellan	$2,168	2030%
Consociate	$2,348	2198%
Hfn	$2,348	2198%
Preferred Plan	$2,710	2537%
Soi Mcfarland	$2,710	2537%
Soi Rushville	$2,710	2537%
Corvel	$2,890	2706%
Methodist First Choice	$2,890	2706%
Mutual Medical Plans	$3,071	2875%
Liability	$3,613	3383%

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 $3,613.
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 Memorial 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.