CMS Price Transparency Data

CT scan, sinuses

Facility: Warner Hospital and Health Services

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $2,269
Cash Discount Price: $2,785
vs. Medicare Baseline: 21.24x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Warner Hospital and Health Services is $2,269. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,785. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 21.24x the Medicare baseline. Located in 422 W White St, Clinton, IL.

Cash / Self-Pay

$2,785

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,269

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: $2,785 (2607%)

Insurance Median: $2,269 (2124%)

Cash: $2,785 (2607% of Medicare)

Ins. Median: $2,269 (2124% 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 2124% of the Medicare baseline (a markup of 2024%). 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
Aetna	$405 - $2,397	379%
Blue Cross Blue Shield	$405 - $2,764	379%
Harmony Hp Mcaid-All Plans	$405	379%
Medicaid / KanCare	$405	379%
Meridian Hp-All Plans	$405	379%
Molina-All Other Plans	$405	379%
Health Alliance Med Adv	$1,127 - $1,156	1055%
Humana	$1,127 - $2,397	1055%
Molina Mcr/Mcd Dual	$1,127 - $1,156	1055%
UnitedHealthcare	$1,127 - $2,397	1055%
Wellcare Mcr Adv-All Plans	$1,127 - $1,156	1055%
Healthlink Hmo	$2,144 - $2,200	2007%
City Of Clinton (Employees Serv)-All Plans	$2,199 - $2,256	2059%
Cigna	$2,282 - $2,341	2137%
Caterpillar-All Plans	$2,337 - $2,397	2188%
Multiplan Phcs-All Plans	$2,337 - $2,397	2188%
Health Alliance-All Other Plans	$2,419 - $2,482	2265%
Healthlink Ppo/Work Comp-All Other Plans	$2,419 - $2,482	2265%
Consociate Care Ppo-All Plans	$2,474 - $2,538	2316%
Hfn Ppo/Epo-All Plans	$2,474 - $2,538	2316%
Three Rivers-All Plans	$2,611 - $2,679	2445%

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 $2,785.
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 Warner Hospital and Health Services 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.