CMS Price Transparency Data

CT scan, sinuses

Facility: Community Hospital of Staunton

Billing Code: 70486 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 70486
Insurance Median: $1,715
Cash Discount Price: $1,072
vs. Medicare Baseline: 16.06x Medicare

The contracted insurance negotiated median rate for a CT scan, sinuses at Community Hospital of Staunton is $1,715. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,072. Compared to the federal Medicare reimbursement reference rate of $106.81, this hospital’s rate is 16.06x the Medicare baseline. Located in 400 N Caldwell St, Staunton, IL.

Cash / Self-Pay

$1,072

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,715

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: $1,072 (1004%)

Insurance Median: $1,715 (1606%)

Cash: $1,072 (1004% of Medicare)

Ins. Median: $1,715 (1606% 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 1606% of the Medicare baseline (a markup of 1506%). 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
Tricare	$117 - $620	110%
Medicare (plans)	$120 - $643	112%
Clear Spring Health Ma	$124 - $652	116%
Medicaid / KanCare	$221 - $2,143	207%
Self Pay	$1,072	1004%
Cigna	$1,380	1292%
Blue Cross Blue Shield	$1,607 - $2,143	1505%
Healthlink	$1,607 - $1,822	1505%
Health Alliance Commercial	$1,715 - $2,143	1606%
Aetna	$1,736 - $2,143	1625%
Multiplan/Phcs	$1,822	1706%
Beech Street	$1,950	1826%
UnitedHealthcare	$2,143 - $2,959	2006%

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 $1,072.
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 Community Hospital of Staunton 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.